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68c ph2 exam10
postpartum drugs
| Question | Answer |
|---|---|
| RHo (D) Immune Globulin: RhoGAM, Rhophylac, BayPho-D | Action: Prevents production of anti-Rh (D) antibodies Indications: Administered to Rh-negative women Adverse Reactions: Pain, fever, or both |
| RhoGAM Nursing Implications: Timeframes: | At 28 weeks of pregnancy 72 hours of delivery 72 hours after termination pregnancy Type and antibody screen Rh-negative and negative for Rh antibodies Medication administered for unknown fetal blood type |
| Vaccines: Rubella vaccine (Meruvax II) | Action: Produces a modified rubella (German measles) Indications: After childbirth, abortion or a 4 weeks before pregnancy Adverse Reactions: Transient arthritis are most common |
| Rubella Nursing Implications | Pregnancy not advised until 4 weeks Vials refrigerated. Discard within 8 hours Protect from light Check with health care provider before giving near time of RhoGAM administration |
| Non Opiod: Pain Medications | - Acetaminophen (Tylenol, Panadol). - Ibuprofen (Motrin, Advil). - Ketorolac (Toradol). |
| Opioid: Pain Medications | Darvocet-N Lortab Tylox Percocet Vicodin Tylox |
| Simethicone: (Mylicon): | This is an antiflatulant medication. Help with relieving gas. |
| Oxytocin: (Pitocin): | Action: Stimulates uterine contractions Indications: Control postpartum hemorrhage. Adverse Reactions: Coma, seizures, tachycardia, cardiac dysrhythmias |
| Oxytocin: (Pitocin): Nursing Considerations: Implementation: | Observe for firmness, height, and deviation. Massage until firm. Do not administer oxytocin simultaneously |
| Methylergonovine maleate (Methergine) | Action: Stimulates contraction and causes arterial vasoconstriction Indications: Prevention and treatment of postpartum or post-abortion hemorrhage Adverse Reactions: N&V, uterine cramping |
| Methylergonovine maleate (Methergine) Nursing considerations: Patient/Family Teaching: | Before administering assess B/P Avoid smoking Do not skip dose or double up if missed |
| Carboprost tromethamine (Hemabate, Prostin): | Action: Stimulates contraction Indications: Treatment of postpartum hemorrhage and abortion. Adverse Reactions: Excessive dose may cause titanic contraction and/or uterine rupture |
| Carboprost tromethamine (Hemabate, Prostin): Nursing Considerations: | Refrigerated Give IM injection Rotate sites Monitor vital signs Administer antiemetics and antidiarrheals as ordered |
| Phytonadione (Vitamin K1, AquaMEPHYTON, Mephyton)Indications: Prevention and treatment of hypoprothrombinemia, which may be associated with: | Excessive doses of oral anticoagulants Salicylates Certain anti-infective agents Nutritional deficiencies Prolonged total parenteral nutrition. Prevention of hemorrhagic disease of the newborn |
| Vitamin K | Action: Required for hepatic synthesis of blood coagulation factors II (prothrombin), VII, IX, and X. Therapeutic Effects: prevention of bleeding due to hypoprothrombinemia |
| Vitamin K Side Effects: | GI: gastric upset, unusual taste Derm: flushing, rash, urticaria Hemat: hemolytic anemia Local: erythema, pain at injection site, swelling Misc: allergic reactions, hyperbilirubinemia (large doses in very premature infants), kernicterus |
| Vitamin K Interactions: Nursing Implications: | Counteract the effect of warfarin. Salicylates or broad-spectrum anti-infectives Monitor for bleeding (guaiac stools, Hematest urine, and emesis) Children are more sensitive to the adverse side effects Evaluation: Prevented hemorrhage |
| Ophthalmic Ointments Erythromycin Ophthalmic Ointment Tetracycline Ophthalmic Ointment | Action: Inhibits protein synthesis in bacteria Indication: Prophylaxis against neisseria gonnorhea. Adverse Reactions: Burning, itching, irritation, blurred vision |
| Ophthalmic Ointments | Nursing Considerations: Do not rinse. Ointment may be wiped from the outer eye after 1 minute. Observe for irritation |
| Hepatitis B Vaccine (Recombivax, Engerix-B): | Action: Provides immunization against Hepatitis B infection Indications: Prevention of hepatitis B in exposed and unexposed infants. Adverse Reactions: Pain or fever |
| Hepatitis B Vaccine (Recombivax, Engerix-B): | Nursing Considerations: Shake well before preparing Given within 12 hours of birth to infected mother Do not inject IV or intradermally Bathe infants before the injection Need parental consent |
| HEPATITIS B IMMUNE GLOBULIN (HBIG) | Action: Antibodies and passive immunity Indications: Prophylaxis for infants of hepatitis B surface antigen-positive mothers. Adverse Reactions: Pain at the site, urticaria, anaphylaxis |
| HEPATITIS B IMMUNE GLOBULIN (HBIG) | Nursing Considerations: Do not shake or give IV. Bathe infants before the Given within 12 hours of birth Separate sites for vaccine and immune globulin |
| The nurse should expect medical intervention for subinvolution to include: | oral methylergonovine maleate (Methergine) for 48 hours. |
| Before administering methylergonovine (Methergine), the nurse checks the: | blood pressure. |
| Which of the following is a common side effect of Hemabate? | Elevated BP |
| Which drug is NOT used in the treatment of postpartum atony and hemorrhage? | Nifedipine |
Created by:
grayman94