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Meds for complications of pregnancy

Terbutaline (aka Brethine) Beta adrenergic used for pre term labor
Terbutaline is administered how? Oral IV Sub Q injection
Side effects of Terbutaline Nervousness restlessness insomnia headache tachycardia Nausea hyperglycemia
Rare but serious side effect of Terbutaline Pulmonary edema
Fetal effects of Terbutaline tachycardia
What med can reverse severe adverse effects? Propranolol
Nursing care for Terbutaline Assess: apical HR and lung sounds before administering fetal HR Notify doc if maternal HR >120 , fetal HR >160bpm or wet lung sounds
Magnesium sulfate Decreases frequency and duration of contractions
Magnesium sulfate is administered how? IV loading dose 4-6gms Maintenance dose 1-4 g/hr to stop ctx
Magnesium sulfate protocol presence of DTR (knee jerk) Urine output of at least 30ml/hr Respirations at least 12/ min
Maternal Side effects of Magnesium sulfate extreme warmth perspiration flushing N/V blurred vision lightheadedness lethargy constipation muscle weakness
Maternal Severe side effects of Magnesium sulfate Chest pain SOB fluid build up in lungs low B/P and fast pulse
Fetal side effects of Magnesium sulfate Decreased variability of FHR Lethargic and may experience difficulty breathing after birth Infants of moms treated w/ drug more often admitted to ICN
Nursing management of Magnesium sulfate follow protocol: DTR's (knee jerk) output RR monitor heart and lung sounds serum magnesium levels FHR monitoring Calcium gluconate antidote Monitor I&O b/c it is excreted by kidney
Nifedipine Prevents preterm ctx Does not stop labor if it is truly labor
Nifedipine is administered how? orally
How does Nifedipine work? blocks passage calcium into tissues, relaxing uterine muscles and blood vessels throughout body
Side effects of Nifedipine dizziness, lightheadedness, skin flushin/ redness, headache, nausea, muscle cramps or tremors, hypotension
Nursing Implications for Nifedipine Check B/P report pulse >110 DO NOT USE WITH MAGNESIUM SULFATE Monitor for fetal effects: fetal bradycardia, transient fetal tachycardia
Antibiotics Used for infection both systemic and local strong association w/ PTL and PROM Lab work (cultures may take 24-48 hours) Amniocentesis for chorioamnionitis
Broad spectrum antibiotics used Ampicillin or Penicillin Erythromycin or Clindamycin Metronidazole
Ampicillin or Penicillin dosage 2Gm IV q 6 hrs x 2 days then 250mg po q8 hrs x 1 day
Erythromycin or Clindamycin 250mg IV q6 hrs x 2 days then 333 mg po 8hrs x 1 day
Corticosteroids ACOG recommended for infants delivering prior to 34 wks Given to speed lung maturation if <34 wks Delay birth for 24 hrs to give benefit
Teaching for Corticosteroids teach patient signs of pulmonary edema
Corticosteroids Dose and Route Betamethasone: 12mg 2 doses IM (mom) 24 hrs apart Dexamethasone: 6 mg 4 doses IM (mom) 12 hrs apart
Progesterone Give to those who are high risk for preterm delivery and have prior hx of PTB It is Preventative, not treatment once PTL has started
Progesterone Dose and Route Given IM q week beginning around 16-20 weeks and continuing through 36 wks
Created by: Jaycee420