Week 4 Flashcards
Pregnancy and preterm labor
Role of placenta
Medication use - prescription, otc
Fetus
Teratogens
Therapeutic drug and herbal use
Can mess with other meds that patient is taking
Iron
Iron-rich foods, prenatal (only needed when recommended), administration = tabs or caps
Folic acid
Vitamin b9 or folate, take before pregnant, baby at risk for Spina Bifida if not, in addition to foods high in folic acid
Preterm labor and delivery
20-37 weeks
Maternal risk factors
Non-pharmacological therapy
Tocolytic therapy - drugs to decrease uterine contractility, provide additional time for fetal growth, administer corticosteroids, transport to facility,
Magnesium sulfate
Keep baby in, calcium antagonist, competes with calcium for entry into cell, relaxes uterine smooth muscle
Side effects, ADRs of magnesium sulfate
SE - flushing, warmth, dizziness, lethargy, nasal congestion
ADRs - confusion, absent reflexes, cardiac depression, respiratory depression
Nursing interventions - magnesium sulfate
Use infusion pump Monitor VS and activity - mom and fetus Mg levels as ordered Assess DTRs - deep tendon reflex (can decrease, but have to monitor closely, see if some reflexes are still noticeable) Antidote available - calcium gluconate
Corticosteroid therapy
Just for baby Betamethasone Off label use Accelerates fetal lung maturation Decrease severity/incidence of respiratory distress syndrome in newborn Increase preterm infant survival Given 48 hrs before delivery Not effective after birth
Surfactant therapy in preterm birth
Synthetic surfactant - beractant, calfactant, poractant
Use - prevent rds or reduce severity
ET tube or nasal
Positioning of neonate
Drugs that enhance uterine contractility
Uterotropic, oxytocic - stimulate uterine smooth muscle
Oxytocin (pitocin) - pit drop
Brain creates oxytocin
Induction or augmentation; post delivery to keep uterus contracted
High - alert drug, schedule 4, intranasal for lactation
Preeclamptic, health issues for both mom/baby
Postpartum and newborn drugs
Pain relief, bowl function
Don’t during lactation
Immunizations for mom
Rh(D) immune globulin
RhoGAM
Rh-negative mom + Rh-positive fetus = risk for Rh sensitization in mom
Risk in subsequent pregnancies - hemolytic problems in fetus/newborn
26-28 weeks, after abortion, amniocentesis, within 72 hours of birth, give IM in deltoid
Drugs for newborn
Erythromycin eye ointment STDs
Vitamin K, phytonadione (aqua-mephyton) - IM, blood clotting for baby, prevent brain bleeds
Immunizations for baby
Hepatitis B vaccine Give regardless of moms status 1st - within 12 hrs 2nd - 1-2 months 3 - at 6 mo Thigh - vastus lateralis
