NCLEX-PN Pharmacology Maternity & Newborn

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Author:
s1akr
ID:
13952
Filename:
NCLEX-PN Pharmacology Maternity & Newborn
Updated:
2010-04-11 17:11:01
Tags:
nclexpn pharm ob
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Description:
meds needs to know for nclex-pn related to ob and neos
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  1. Oxytocin (Pitocin)

    Action:
    Stimulates the smooth muscle of the uterus and induces contraction of myocardium
  2. Oxytocin (Pitocin)

    ADR:
    • dysrhytmias
    • changes in BP
    • uterin rupture
    • water intoxication
    • high doses; hopotension w/ rebound hypertension
  3. Oxytocin (Pitocin)

    Interventions:
    • If uterine hyperstimulation or nonreassuring FHR occurs:
    • medication is stopped
    • turn client on her side
    • O2 vis face mask
    • notify RN
  4. Ergot Alkaloids

    Drug names:
    • Ergonovine (Ergotrate)
    • Methylergonovine (Methergine)
  5. Ergot Alkaloids

    Action:
    • directly stimulate uterine muscle
    • increase the force & frequency of contractions
    • produce arterial vasoconstriction
    • vasospasm of the coronary arteries
  6. Ergot Alkaloids

    ADR:
    • nausea
    • uterine cramping
    • bradycardia
    • dysrhythmias
    • MI
    • severe hypertension
  7. Ergot Alkaloids

    Contraindication:
    • pregnancy
    • clients with significant cardiovascular disease,
    • peripheral vascular disease
    • hypertension
    • eclampsia
    • preeclampsia
  8. Prostaglandins

    Actions:
    potent stimulators of the myometrium
  9. Prostaglandins

    Drug names:
    • Carboprost (Hemabate)
    • Dinoprostone (Cervidil)
  10. Prostaglandins

    ADR:
    • diarrhea
    • nausea
    • vomiting
    • stomach cramps
    • fever
    • chills
    • flushing
    • dysrhythmias
    • bronchoconstriction
    • chest pain
    • hypertension
    • peripheral vasoconstriction
    • uterine cramping & tetany
  11. Prostaglandins

    Interventions:
    • remain with client 30 min after administration
    • maintain client in a supine position for 30 min after administration
  12. Magnesium sulfate

    Action:
    • CNS depressant and anticonvulsant
    • causes smooth muscle relaxation
  13. Magnesium sulfate

    Antidote:
    Calcium gluconate
  14. Magnesium sulfate

    ADR:
    • reduced respiratory rate
    • decreased relflexes
    • flushing
    • hypotension
    • decreased hear rate
    • loss of deep tendon reflexes
    • heart block
    • respiratory paralysis
    • cardiac arrest
  15. Magnesium sulfate

    Contraindication:
    • heart block
    • myocardial damage
    • renal failure
  16. 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
  17. Meperidine hydrochloride (Demerol)

    Action:
    Narcotic analgesic
  18. Meperidine hydrochloride (Demerol)

    Antidote:
    Naloxone (Narcan)
  19. 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
  20. Meperidine hydrochloride (Demerol)

    Interventions:
    • monitor v/s; RR under 12/min notify RN
    • monitor BP changes
    • have antidote ready
  21. Rho(D) Immune Globulin (RhoGAM)

    Action:
    Prevention of anti-Rh(D) antibody formation
  22. Rho(D) Immune Globulin (RhoGAM)

    ADR:
    • elevated temp
    • tenderness at the injection site
  23. Rho(D) Immune Globulin (RhoGAM)

    Intervention:
    • administered to mother at 28 week gestation and within 72 hours after delivery
    • monitor temp
    • monitor injection site
  24. Betamethasone (Celestone)

    Description:
    • corticosteroid
    • increases production of surfactant
    • used in preterm labor; can be inhibited for 48 hours
  25. Betamethasone (Celestone)

    ADR:
    decreases mother's resistant to infection
  26. Betamethasone (Celestone)

    Interventions:
    • monitor v/s
    • monitor signs of infection
  27. Lung surfactant

    Description:
    • replenishes surfactant and restore surface activity to the lungs
    • administered by the intratracheal route
    • prevent or treat RDS in preterm infants
  28. Lung surfactant

    Drug names:
    • Beractant (Survanta)
    • Colfosceril palmitate (Exosurf)
  29. Lung surfactant

    ADR:
    • transient bradycardia
    • oxygen desaturation
  30. Lung surfactant

    Interventions:
    • avoid suctioning at least 2 hours after administration
    • monitor for bradycardia and oxygen saturation
    • check lung sounds for moist breath sounds
  31. Erythromycin (0.5% Ilotycin) and tetracycline (1%)

    Description:
    • bacteriostatic and bactericidal
    • prophylaxis vs gonorrhea and chlamydia

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