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Maternity Pharm
Mother Baby Drug Quiz
| Question | Answer |
|---|---|
| B vitamin that helps to prevent neural birth defects (Brain and spine) | Folic Acid |
| Woman wishing to get pregnant should start taking folic acid | One month before they plan to get pregnant |
| Dosage for folic acid in normal circumstances | 400 mcg orally daily for the first 12 weeks of the pregnancy |
| Woman who have had an infant with a neural defect folic acid dose | 800+ mcg |
| Folic acid adverse effects | Usually none but woman may complain of loss of appetite |
| Folic acid interactions | Green Tea decreases bioavailability |
| Who naturally has low folic acid ? | Hispanic and Latina woman |
| Foods high in Folic acid | Asparagus Broccoli Spinach Egg Peas Beans Deep green leafy vegetables |
| Who gets Rubella titers? | All woman when they begin pre-natal care. |
| What vaccine causes fetal demise? | Measles, Mumps, Rubella, (MMR) vaccine (Because it's a live vaccine) |
| How long after getting the MMR should you wait to get pregnant? | 1-3 Months |
| Who gets Rhogam? | Rh negative Mom’s to prevent Rh incompatibility |
| What happens of you don't get Rhogam and you are RH Negative but your BD is RH positive? | Mom’s negative antibodies attacks the unborn baby’s positive antibodies and can cause the baby to die |
| How is Rhogam administered? | IM injection in the deltoid muscle |
| When is Rhogam is administered? | Between 26-28 weeks pregnancy Within 72 hours after delivery After an amniocentesis After an abortion After abdominal trauma: MVA, Domestic violence Any bleeding during pregnancy Given every pregnancy even the first one |
| What is given after an amniocentesis? | Rhogam |
| What is given after an abortion? | Rhogam |
| What is given after abdominal trauma: MVA, Domestic violence? | Rhogam |
| Which pregnancy should an Rh- Mom get the Rhogam shot? | Every pregnancy even the first one |
| Adverse effects of Rhogam | Drowsiness Pain at injection site Fever |
| When is FENTANYL used? | During labor for pain control |
| How is fentanyl given? | Through the Epidural catheter |
| When is the epidural inserted | Mom is dilated to at least 4cm. |
| Who can administer Fentanyl? | Anesthesiologist or CRNA |
| What should you do after mom gets fentanyl? | Take blood pressure every 5 minutes after block and each time reinjection until stable Monitor Fetal Heart Rate Insert foley catheter |
| Fentanyl patient education | Explain contractions may slow Explain frequent vital sign and fetal heart rate checks |
| NARCAN | NALOXONE |
| NARCAN (NALOXONE) purpose | Reverses an opioid overdose. Blocks effects on the brain by opiates and restores breathing |
| Narcan dosage | 2 mg iv (may be repeated) |
| Narcan routes | IV Nasal |
| Why would they need it again within 15 minutes? | The half life of Narcan is shorter then the half life of the narcotic |
| How long should you stay with your patient after giving narcan? | 15 minutes |
| Narcan adverse effects | Nausea Headache Sweating |
| NARCAN NURSING IMPLICATIONS | Assess respiratory rate Assess need to re administer |
| Why is magnesium sulfate given? | To prevent seizures in pre-eclampsia and eclampsia |
| What kind of medication is Magnesium sulfate? | High alert |
| When magnesium sulfate is given to stop preterm labor | It doesn’t work great but can protect the brain and possibly decrease chance of cerebral palsy |
| Magnesium sulfate dose | 4 gram IV loading dose over 30 minutes Maintenance dose 1-2 grams per hour continuous IV |
| Magnesium sulfate adverse effects | Absent deep tendon reflexes Respiratory depression Pulmonary edema Cardiac arrhythmias Flushing Feeling uncomfortably warm Dry mouth Nausea Blurred vision |
| Magnesium sulfate nursing interventions | Vital signs, pulse oximetry Monitor deep tendon reflexes Intake and output Signs and symptoms of labor progression |
| Magnesium concentration in blood that make you lose deep tendon reflexes | Level greater then 9mmol/ |
| Magnesium sulfate antidote | Calcium gluconate |
| Calcium gluconate | Antidote to magnesium sulfate |
| What is the antidote to magnesium sulfate | Calcium gluconate |
| Why is Calcium gluconate given? | Magnesium blood concentration greater than 9 |
| WHAT ARE CERVICAL RIPENING AGENTS? | These agents work to physically soften the cervix which leads to dilation and effacement |
| Why are cervical ripening agents given? | Labor induction or abortions |
| Why would you avoid cervical ripening agents? | Previous cesarean section Uterine surgery History of a difficult labor Multipara pregnancy Clients who suffer from hypersensitivity disorders Fetal distress |
| If your baby is in Fetal distress | You shouldn't give a cervical ripening agent |
| Clients who suffer from hypersensitivity disorders | Shouldn't be given a cervical ripening agent |
| Patients with a multipara pregnancy | Shouldn't be given a cervical ripening agent |
| Women with a history of difficult labor | Shouldn't be given a cervical ripening agent |
| If you've had uterine surgery | You shouldn't be given a cervical ripening agent |
| Previous cesarean section means | You can't get a cervical ripening agent |
| DINOPROSTONE | CERVIDIL |
| WHY DINOPROSTONE (CERVIDIL) USED? | To help a pregnant woman relax the muscles of the cervix to prepare to induce labor |
| WHY IS DINOPROSTONE (CERVIDIL) GIVEN? | Cervical ripening Pregnancy termination |
| DINOPROSTONE (CERVIDIL) ADMINISTRATION | 20 mg given has a vaginal suppository Vaginal suppository is removed when labor starts or after 12 hours Client needs to stay in bed for 2 hours after insertion |
| DINOPROSTONE DOSE | 20 mg vaginal suppository |
| WHEN SHOULD YOU REMOVE DINOPROSTONE? | When labor starts or after 12 hours |
| HOW LONG DOES A WOMAN STAY IN BED AFTER GETTING CERVIDIL? | 2 HOURS AFTER INSERTION |
| DINOPROSTONE (CERVIDIL) ADVERSE EFFECTS | Hypotension Headache Uterine rupture Back pain Vaginitis Fever Diarrhea |
| DO NOT GIVE DINOPROSTONE (CERVIDIL) | IF MEMBRANES HAVE RUPTURED |
| DINOPROSTONE (CERVIDIL) NURSING INTERVENTIONS | Monitor uterine activity, fetal status and progression of cervical dilatation and effacement Remove Cervidil as labor begins or if fetal distress develops Check vaginal discharge |
| MISOPROSTOL | CYTOTEC |
| WHY IS CYTOTEC USED? | Peptic ulcer disease Pre induction medication usually delivery happens within 24 hours |
| CYTOTEC DOSE | 25 mcq |
| CYTOTEC ROUTE | PO, Sublingual, or buccal, vaginally |
| MISOPROSTOL ADVERSE EFFECTS | Uterine tachysystole (increased uterine contractions) Fever Nausea Vomiting Diarrhea Chills Dizziness |
| Uterine tachysystole | Increased uterine contractions |
| MISOPROSTOL (CYTOTEC) CONTRAINDICATIONS | If taking this drug for peptic ulcer disease the drug would need to be changed when the woman became pregnant. Can cause an abortion |
| CYTOTEC NURSING INTERVENTIONS | Bedrest 1 to 2 hours after insertion Monitored for uterine contractions Monitor vital signs and Fetal Heart Rate |
| OXYTOCIN | PITOCIN |
| OXYTOCIN (PITOCIN) USE | LABOR INDUCTION |
| WHEN IS PITOCIN GIVEN | AFTER cervical ripening drugs given and worked |
| What happens if oxytocin is given before the cervix is ripe? | can cause the woman to need a C-Section |
| How does oxytocin help to reduce post partum bleeding | It can help the uterus contract |
| OXYTOCIN ADMINISTRATION | IV: Continuous infusion |
| How soon after beginning oxytocin should you start contracting? | About 30 minutes after the injection |
| CONTRAINDICATIONS TO OXYTOCIN | Fetal distress Hydramnios (large amount of amniotic fluid) Partial placenta preavia |
| Hydramnios | Large amount of amniotic fluid |
| OXYTOCIN ADVERSE EFFECTS | Uterine rupture Nausea, vomiting More intense and frequent contractions |
| OXYTOCIN NURSING IMPLICATIONS | Monitor uterine contractions Monitor fetal heart rate Monitor vital signs Monitor intake and output |
| OXYTOCIN EDUCATION | Reason why drug is given Why you do the monitoring Report any adverse effects |
| Abrysvo | Given to pregnant women at 32–36 weeks to protect newborns from RSV-related lower respiratory tract disease. |
| Why must Abrysvo be given in the 32-36 week timeframe? | Given before 32 weeks may trigger preterm labor. Given after 36 weeks may not fully protect the baby. |
| ABRYSVO adverse effects | Pain at injection site Headache Muscle pain Nausea Low Birth weight in babies Jaundice in babies Fatigue |
| What time in the year is abrysvo given? | September–January in some states; timing may vary in southern states based on RSV season. |
| TOCOLYTIC MEDICATIONS | Used to delay or STOP premature uterine contractions during pregnancy. |
| Why would you need to delay or stop premature uterine contractions? | Fetal heart maturation Transport to specialized care Breech presentation :Helps to relax Mom’s muscles when MD helps to change from a breech presentation |
| What type of medication is given to allow the fetal heart time to mature? | Tocolytic Medications |
| What medication is given to a laboring mother to delay birth for transport to specialized care? | Tocolytic Medications |
| Why is a tocolytic medication given when the baby is presenting breech? | Relaxes mom’s muscles to help breech position change. |
| NILFEDIPINE | Procardia |
| WHAT IS NILFEDIPINE? | Calcium channel blocker used to delay preterm birth. |
| When is Procardia given? | Given between 24-34 weeks |
| How does Nilfedipine work? | Relaxes smooth muscle to decrease contractions |
| How many doses of nilfedipine can be given | 3 times total Loading dose 20 mg p.o. contractions after 20 min 10 mg p.o. if another 20 min contractions give 10 more |
| Can you chew or crush Nilfedipine(Procardia)? | NOOOOOO!!! |
| What do you do if the contractions continue after all 3 doses of Procardia? | Use another tocolytic drug |
| NILFEDIPINE (Procardia) Adverse Effects | Flushing Headaches Nausea Dizziness Transient maternal hypotension Transient maternal tachycardia |
| NILFEDIPINE (Procardia) Contraindications | Fetal death Eclampsia Concurrent use of Magnesium sulfate Maternal Heart Failure |
| When should the baby be monitored after getting Procardia? | Continuous fetal monitoring |
| TERBUTALINE use | Used to delay preterm labor for 72+ hours. |
| TERBUTALINE CONTRAINDICATIONS | Heart disease High blood pressure Seizures Overactive thyroid |
| TERBUTALINE Administration | SQ or IV. May have a pump (like an insulin pump) Usually injected into the shoulder |
| How many times can Terbutaline be given before you try the next drug? | 2 times total |
| How long can Terbutaline be used? | Cannot be used for more than 2 days |
| Why is Terbutaline not commonly used ? | Causes Maternal Death |
| Terbutaline Adverse Effects | Racing Pulse MI Hyperglycemia Tremors Restlessness Paradoxical bronchospasm (Wheezing, cough, dyspnea, tightness in chest and throat) Convulsion Tachycardia |
| TERBUTALINE NURSING IMPLICATIONS | 1. Monitor to see if contractions stop 2. Watch blood sugar in mom |
| Why is Betamethasone Given? | To lower risk of preterm labor within 7 days |
| How many doses of Betamethasone can be given? | ONLY ONE! |
| What gestation is Betamethasone Given? | 24-33 weeks |
| How does Betamethasone speed fetal lung development ? | Helps the release of surfacant. |
| Why is Surfacant needed? | To help open the alevoi in the lungs to help with breathing. |
| What type of medication is Betamethasone? | A steroid |
| BETAMETHASONE ADMINISTRATION | 1 deep IM injection ONLY ONE! |
| BETAMETHASONE Adverse Effects | Temporarily reduced fetal movements Headache Nausea and vomiting |
| METHERGINE | METHYLERGOMETRINE |
| What type of medication is METHERGINE ? | Uterotonic medication |
| What does Methergine do? | Causes uterine contractions to treat atony and prevent postpartum hemorrhage. |
| WHY IS METHERGINE (METHYLERGOMETRINE) USED? | Used for abortion or to control postpartum uterine bleeding. |
| METHERGINE (METHYLERGOMETRINE) ADVERSE EFFECTS | Decrease in Milk Production Dizziness Vomiting Sweating Seizures Headache Foul taste in their mouth |
| METHERGINE (METHYLERGOMETRINE) Contraindications | Hypertension Cardiac disorders |
| Why shouldn't the mom breastfeed after taking Methergine? | Drug can pass to the infant |
| How soon after the last dose of Methergine can the mother begin breastfeeding? | 12 hours |
| METHERGINE (METHYLERGOMETRINE) Nursing implications | Check BP before beginning dose Monitor Mom's vital signs. Monitor how much bleeding Did the bleeding stop |
| METHERGINE (METHYLERGOMETRINE) ADMINISTRATION | IM IV P.O. |
| What can cause continuous contractions? | METHERGINE to help the bleeding stop |
| Why should the blood pressure be especially monitored when taking methergine? | It can cause blood pressure to increase |
| CARBOPROST | HEMABATE |
| CARBOPROST USE | Used to induce abortion; mainly treats postpartum hemorrhage. |
| CARBOPROST (HEMABATE) ADMINISTRATION | IM 250 mcg; repeat every 15–90 mins as needed. |
| CARBOPROST (HEMABATE) contraindications | Active renal disease Hepatic disease |
| CARBOPROST (HEMABATE) ADVERSE EFFECTS | Headache Vomiting Increase in uterine bleeding Fever Short of breath |
| How long should you delay breast feeding after taking Hemabate? | 6 hours after administration |
| CARBOPROST (HEMABATE) NURSING IMPLICATIONS | Monitor for signs of wheezing, chest tightness, dyspnea, rash, swelling of face, lips or throat |
| ZURZUVAE | ZURANOLONE |
| ZURZUVAE USE | Postpartum depression |
| Zurzuvae Dose | P.O. Take once daily (at night) with fatty food for 14 days. If missed, skip and continue regular dosing. |
| ZURZUVAE (ZURANOLONE) ADVERSE EFFECTS | Somnolence Dizziness Diarrhea Fatigue Urinary Tract Infection May decrease alertness and awareness |
| How soon after Zurzuvae can you drive? | 12 Hours |
| ZURZUVAE (ZURANOLONE) CLIENT EDUCATION | May be at high risk for falls Report any suicidal tendencies to HCP Do not drink alcohol when taking drug Tell HCP if breast feeding not sure if it passes in breast milk If taking opioids during treatment may cause CNS depression |
| EXAMPLES OF FAT CONTAINING FOODS | Avocadoes Nuts Dark chocolate Whole eggs Butter Olive oil Cheese Whole milk Ice cream |
| Before starting birth control | Sure! Here's the shortest version: --- OB History STI screening HCG test |
| ABSTINENCE | Sure! Here's a concise version: --- 100% Effective Best STI protection |
| Track Ovulation through Basal Body Temperature | Take temp on waking, before activity Temp drop, then rise = ovulation Rise stays through menstruation Ovulation may have already happened No sex for 3 days after rise if avoiding pregnancy 9% failure rate |
| Issues that can impede the temperature increase | Poor Sleep Alcohol the night before Illness Jet lag Sleeping late Sleeping under a heated electric blanket |
| Cervical Mucus: Billings Method | Hormones change mucus during cycle After period: thick, sticky, white Near ovulation: thin, clear, slippery (helps sperm) |
| Calendar (Rhythm) Method | Track cycle for months Predict ovulation if regular Fertile: 5 days before, 1 day after Use barriers during fertile days Only works with regular cycles |
| Ovulation Predication Kit | OTC test detects LH surge 12–24 hrs before ovulation Uses urine sample 98–99% accurate Popular choice Costs $26.99–$150 |
| Chemical Barriers | Spermicides: Kill sperm, lower vaginal pH OTC purchase No STI protection 80% fail rate (when used alone) |
| Male or Female Condom | Can be used with spermicidal gel/cream for more effectiveness Protects against STI Risk: can rupture or leak |
| Diaphragm and Spermicide | Blocks sperm, with spermicide Fitted by provider Replace every 2 years, Refit after weight change, surgery, or pregnancy Keep in 6 hrs after sex Not for those with Toxic Shock Syndrome history |
| Cervical Cap | Silicone cap, fits around the cervix Available in 3 sizes, fitted by provider Leave in 6-48 hours Replace every 2 years Refit after weight loss, surgery, or pregnancy Clean with soap and water |
| Vaginal Ring | Releases estrogen and progesterone Inserted for 3 weeks, removed in 4th week for menstrual flow Fertile immediately after removal |
| Contraceptive Sponge | Polyurethane with spermicide One-size fits all, covers cervix Leave in 6 hours after intercourse |
| Two types of Hormone Contraception | Combination Estrogen and Progestin Mini pill: Progestin only |
| Contraindications of Hormone Contraception | Breast feeding Age of 35 years old and older Cardiovascular disease Hypertension Diabetes Smoking Cirrhosis |
| Adverse effects and danger signs of Hormone Contraceptives | Chest pain Shortness of breath Leg pain from a potential clot Headache Depression Nausea Weight gain Breast tenderness Vaginal infections |
| Progestin Only Pills | Same effect as combined pills Take daily at the same time Use backup method during the first month Safe for breastfeeding |
| Transdermal Patch Contraceptives | Apply to dry skin avoid breasts Replace weekly for 3 weeks, 1 week off Use for up to 2 years Can take 18 months to conceive after stopping Safe for bathing/swimming If loose for <24 hrs, no backup needed; if >24 hrs, replace and use backup for 1 week |
| Injectable Progestins (DEPO) | Injection every 11-13 weeks (IM) Administer within first 5 days of menstrual cycle Use for up to 2 years Inhibits ovulation, alters endometrium and cervical mucus |
| Intrauterine Device (IUD) | T-shaped, inserted into the uterus Prevents fertilization by causing sterile inflammation Monitor menstrual flow and check strings monthly Effective for 3-10 years 99% effective Risks: Ectopic pregnancy, PID |
| IUD Report to Provider | Late or abnormal spotting Pain with intercourse Abnormal or foul smelling vaginal discharge Change in string length |
| Subdermal implants (nexplanon) | Inserted under the skin during the 7th day of menstrual cycle Effective for 3-5 years 1% fail rate |
Created by:
SANGUT1567
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