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Oxytocin (Pitocin)
Action:
Stimulates the smooth muscle of the uterus and induces contraction of myocardium
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Oxytocin (Pitocin)
ADR:
- dysrhytmias
- changes in BP
- uterin rupture
- water intoxication
- high doses; hopotension w/ rebound hypertension
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Oxytocin (Pitocin)
Interventions:
- If uterine hyperstimulation or nonreassuring FHR occurs:
- medication is stopped
- turn client on her side
- O2 vis face mask
- notify RN
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Ergot Alkaloids
Drug names:
- Ergonovine (Ergotrate)
- Methylergonovine (Methergine)
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Ergot Alkaloids
Action:
- directly stimulate uterine muscle
- increase the force & frequency of contractions
- produce arterial vasoconstriction
- vasospasm of the coronary arteries
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Ergot Alkaloids
ADR:
- nausea
- uterine cramping
- bradycardia
- dysrhythmias
- MI
- severe hypertension
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Ergot Alkaloids
Contraindication:
- pregnancy
- clients with significant cardiovascular disease,
- peripheral vascular disease
- hypertension
- eclampsia
- preeclampsia
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Prostaglandins
Actions:
potent stimulators of the myometrium
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Prostaglandins
Drug names:
- Carboprost (Hemabate)
- Dinoprostone (Cervidil)
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Prostaglandins
ADR:
- diarrhea
- nausea
- vomiting
- stomach cramps
- fever
- chills
- flushing
- dysrhythmias
- bronchoconstriction
- chest pain
- hypertension
- peripheral vasoconstriction
- uterine cramping & tetany
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Prostaglandins
Interventions:
- remain with client 30 min after administration
- maintain client in a supine position for 30 min after administration
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Magnesium sulfate
Action:
- CNS depressant and anticonvulsant
- causes smooth muscle relaxation
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Magnesium sulfate
Antidote:
Calcium gluconate
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Magnesium sulfate
ADR:
- reduced respiratory rate
- decreased relflexes
- flushing
- hypotension
- decreased hear rate
- loss of deep tendon reflexes
- heart block
- respiratory paralysis
- cardiac arrest
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Magnesium sulfate
Contraindication:
- heart block
- myocardial damage
- renal failure
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Magnesium sulfate
Interventions:
- monitor v/s; especially RR every 30 - 60 min
- notify RN if RR below 12/min
- monitor renal and cardiac function
- monitor magnesium levels
- keep calcium gluconate on hand
- deep tendon reflexes monitored hourly
- patellar reflex tested before administering repeat parenteral dose
- patellar reflex must be present and RR must be above 16/min before each parenteral dose
- monitor i/o hourly; output should be maintained at 30mL/hr
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Meperidine hydrochloride (Demerol)
Action:
Narcotic analgesic
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Meperidine hydrochloride (Demerol)
Antidote:
Naloxone (Narcan)
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Meperidine hydrochloride (Demerol)
ADR:
- dizziness
- nausea
- vomiting
- sedation
- decreased BP
- decreased RR
- diaphoreses
- flushed face
- decreased urination
- RR depression
- skeletal muscle flaccidity
- cold, clammy skin
- cyanosis
- extreme somnolence progressing to convulsions, stupor, and coma
Administered with promethazine (Phenergan) to prevent nausea
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Meperidine hydrochloride (Demerol)
Interventions:
- monitor v/s; RR under 12/min notify RN
- monitor BP changes
- have antidote ready
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Rho(D) Immune Globulin (RhoGAM)
Action:
Prevention of anti-Rh(D) antibody formation
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Rho(D) Immune Globulin (RhoGAM)
ADR:
- elevated temp
- tenderness at the injection site
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Rho(D) Immune Globulin (RhoGAM)
Intervention:
- administered to mother at 28 week gestation and within 72 hours after delivery
- monitor temp
- monitor injection site
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Betamethasone (Celestone)
Description:
- corticosteroid
- increases production of surfactant
- used in preterm labor; can be inhibited for 48 hours
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Betamethasone (Celestone)
ADR:
decreases mother's resistant to infection
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Betamethasone (Celestone)
Interventions:
- monitor v/s
- monitor signs of infection
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Lung surfactant
Description:
- replenishes surfactant and restore surface activity to the lungs
- administered by the intratracheal route
- prevent or treat RDS in preterm infants
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Lung surfactant
Drug names:
- Beractant (Survanta)
- Colfosceril palmitate (Exosurf)
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Lung surfactant
ADR:
- transient bradycardia
- oxygen desaturation
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Lung surfactant
Interventions:
- avoid suctioning at least 2 hours after administration
- monitor for bradycardia and oxygen saturation
- check lung sounds for moist breath sounds
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Erythromycin (0.5% Ilotycin) and tetracycline (1%)
Description:
- bacteriostatic and bactericidal
- prophylaxis vs gonorrhea and chlamydia
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