Week 2

Question 1

Ibuprofen: trade name

Answer 1

Motrin

Question 2

Ibuprofen: indications

Answer 2

• afterpains
• perineal pain

Question 3

Ibuprofen: dosage

Answer 3

• as an analgesic: 200–400 mg q 4–6 hr (not to exceed 1200 mg/day)
• as an anti-inflammatory: 400–800 mg 3–4 times daily (not to exceed 3200 mg/day)

Question 4

Ibuprofen: ADRs

Answer 4

• HA
• dizziness
• constipation
• dyspepsia
• nausea
• GI bleeding
• anaphylaxis

Question 5

Ibuprofen: nursing implications

Answer 5

• encourage mother to take on regular schedule to stay ahead of both perineal and analgesic discomfort
• take w/ full glass of water
• assess pain
• monitor for S/S of GI bleed

Question 6

Oxycodone w/ acetaminophen: trade name

Answer 6

Percocet

Question 7

Oxycodone w/ acetaminophen: indications

Answer 7

• postpartum perineal pain and afterpains

Question 8

oxycodone w/ acetaminophen: dosage

Answer 8

• 0.2 mg/kg q 3–4 hr initially, as needed (oxycodone)
• 325–650 mg q 6 hr (acetaminophen)
  
  • do not exceed 4g of acetaminophen/day

Question 9

oxycodone w/ acetaminophen: ADRs

Answer 9

• orthostatic hypoTN
• confusion
• sedation
• constipation
• HA
• dry mouth
• n/v
• respiratory depression
• atelectasis

Question 10

oxycodone w/ acetaminophen: nursing implications

Answer 10

• teach pt about potential for abuse/opiate dependence
• teach pt not to exceed 4g/day of acetaminophen
• advise pt to make position changes slowly
• do not drink alcohol
• turn, cough, deep breathe to prevent atelectasis
• assess BP, pulse, respirations
• assess pain
• assess bowel function routinely

Question 11

morphine sulfate (long acting): trade name

Answer 11

Duramorph

Question 12

morphine sulfate (long acting): indications

Answer 12

• postpartum CS pain

Question 13

morphine sulfate (long acting): dosage

Answer 13

• epidural:
  
  • intermittently: 5 mg/day (initially); if relief is not obtained at 60 min, 1–2 mg increments may be made
    
    • (total dose not to exceed 10 mg/day.)
• IV: 4–10 mg q 3–4 hr

Question 14

morphine sulfate (long acting): ADRs

Answer 14

• itching
• nausea
• confusion
• sedation
• respiratory depression
• hypoTN
• constipation
• flushing

Question 15

morphine sulfate (long acting): nursing implications

Answer 15

• administer immediately after CS via epidural to give pain relief for 18-24 hours
• change positions slowly
• no alcohol use
• emphasize importance of constipation prevention: fluids, walking, fiber
• assess bowel function routinely
• d/c gradually
• monitor RR, breath sounds
• assess pain

Question 16

Ketorolac: trade name

Answer 16

Toradol

Question 17

Ketorolac: indications

Answer 17

• postpartum CS pain management

Question 18

Ketorolac: dosage

Answer 18

• PO: 20 mg initially, followed by 10 mg q 4–6 hr (not to exceed 40 mg/day).
• IM:
  
  • Single dose– 60 mg.
  • Multiple dosing– 30 mg q 6 hr (not to exceed 120 mg/day).
• IV: same as IM

Question 19

Ketorolac: ADRs

Answer 19

• drowsiness
• dizziness
• n/v
• itching
• GI bleed
• injection site pain
• prolonged bleeding time

Question 20

ketorolac: nursing implications

Answer 20

• avoid using alcohol, NSAIDs, acetaminophen
• should always give initially as IM/IV
• administer IVPB over 15 sec
• assess pain

Question 21

Naloxone: trade name

Answer 21

Narcan

Question 22

Naloxone: indications

Answer 22

• severe respiratory depression in the newborn when the mother has received narcotics w/in 4 hours of delivery

Question 23

Naloxone: dosage

Answer 23

• neonates: 0.1 mg/kg
  
  • can give IM, IV, subQ
    
    • IV is preferred during resuscitation
    • IM is acceptable but may have delayed onset

Question 24

Naloxone: ADRs

Answer 24

• if mother was addicted to opiates, do not give
  
  • may cause withdrawal and seizures
• n/v
• ventricular arrhythmias

Question 25

Naloxone: nursing implications

Answer 25

* note strength of med available when calculating dose * when depression from opiates is expected, prepare syringe before birth by drawing up more than is needed * after birth, calc amt needed for infant's weight * excess is removed from syringe and correct dose given * monitor for response, and be prepared to give repeated doses

Question 26

Simethicone: trade name

Answer 26

Mylicon

Question 27

Simethicone: indications

Answer 27

* Relief of painful symptoms of excess gas in the GI tract that may occur CS

Question 28

Simethicone: dosage

Answer 28

* 40–125 mg qid, after meals and at bedtime * (up to 500 mg/day).

Question 29

Simethicone: ADRs

Answer 29

None significant!

Question 30

Simethicone: nursing implications

Answer 30

* Assess patient for abdominal pain, distention, and bowel sounds prior to and periodically throughout course of therapy. * Frequency of belching and passage of flatus should also be assessed * administer after meals and at bedtime for best results