OB med

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Author:
thaoherbie
ID:
247428
Filename:
OB med
Updated:
2013-11-26 10:05:36
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OB med nursing
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OB, med, nursing
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  1. vitamin K
    • necessary for production of clotting factors
    • given within 1-2 hrs after birth
    • prevent vit K defeciency bleeding
    • IM injection 90 degree in middle 3rd of vastus lateralis, 25 gauge 5/8-in needle
  2. erthyromycin ointment
    • 0.5%
    • provides bactericidal & bacteriostatic actions to prevent gonorrhea & chlamydia conjuctivitis
    • prevent ophthalmia neonatorum
    • be aleart for chemical conjunctivitis for 1-2 days
    • wear gloves, open eys by placing thumb & finger above & below the eye
    • gently squeeze & apply to the conjunctival sac from inner canthus to the outer canthus
    • do not touch the tip to the eye
    • close the eye to make sure the med premeates
    • wipe off excess ointment after 1 min
  3. Hep. B- Engerix, Recombivax
    • administer monovalent Hep.B to all newborn prior to discharge
    • if mom HBsAg (+) -> administer Hep.B & HBIG (Hep.B immune globulin) 0.5 ml within 12 hours of birth
    • If mom HBsAg unknown -> administer Hep.B
    • if mom HBsAg (+) -> can delay Hep.B
  4. Betamethasone
    • promote fetal lung maturity by stimulating surfactant production
    • administer 2 doses IM 24 hrs apart
    • monitor maternal infection or PEdema
    • assess maternal lung sounds
  5. magnesium sulfate
    • relax uterine muscle to stop irritability & contrations, used for seizure prophylaxis & tx of seizures for pre-eclampsia & eclampsia
    • IV loading dose 4-6 g over 15-30 min, then 1-4 g/hour
    • assess VS, DTRs hourly; report any hypotension, depressed or absent DTR
    • monitor level of consciousness, headache, blurred vision, dizziness, altered level of consciousness, resp <12, lung sounds for PEdema
    • monitor FHR, tone, resp.
    • monitor I/O, report if output < 30 ml/hr
    • maternal S/e: flushing, N/V, dry mouth, lethargy, blurred vision, headache
    • toxicity S/s: decreased LOC, depressed RR & DTR, slurred speech, weakness, Resp. cardiac arrest
    • have calcium gluconate ready @ bedside to reverse toxicity
  6. terbutaline sulfate (Brethine)
    • relax smooth muscle to calm uterus
    • inhibit uterine activity to arrest preterm labor
    • effective for delaying up to 48 hrs
    • maternal adverse effects: tachycardia, hypotension, palpitations, tremors, chest pain, hypokalemia, water retention, N/V/D, hyperglycemia, decrease urine output, nervousness
    • discontinue if MHR >120, BP < 90/60, FHR >180, signs of P.Edema
    • have  propranolol (Inderal) available to reverse cardiac adverse effects
  7. demerol
    • 25-50 mg IV or epidural with maximal fetal uptake 2-3 hrs after administration
    • causes CNS depression, decreased fetal variability
  8. stadol
    • 1mg IV q3-4h
    • rapidly transfer across placenta
    • causes neonatal resp. depression
  9. Nubain
    • 10 mg IV
    • causes less maternal N/V
    • decreases FHR variability, fetal bradycardia, resp. depression
  10. oxytocin (Pictocin)
    • stimulates the uterus to contract, control bleeding from the placental site
    • monitor uterine tone to prevent hyperstimulation
    • IV piggyback, proximal to the IV site
  11. Methergine
    • stimulate the uterus/prevent & treat PP hemorrhage due to atony or subinvolution
    • adverse effect: hypertension, seizures, uterine cramping, N/V, palpitations, chest pain
  12. Rhogam
    • suppresses immune response of nonsensitized Rh(-) pt who exposed to Rh(+) blood after abortions, miscarriages & pregnancies
    • IM in deltoid
    • give MICRhoGAM for abortion, miscarriage <12 wks
  13. Narcan
    • opioid reversal agent
    • Antagonist to narcotics (induces withdrawal, stimulates respirations)
    • monitor BP, HR, RR; s/s of opioid withdrawal
    • Short-acting—symptoms of respiratory depression may return; additional doses may be necessary
  14. apresoline
    • peripheral vasodilator
    • monitor BP
    • cause diarrhea, loss of appetite, N/V, headache, nasal congestion
    • report chestpain, palpitation, dyspnea, s/s of tachy arrhythmia, peripheral neuropathy, hypotension, agranulocytosis, SLE, hepatotoxicity
  15. compazine
    • antiemetic
    • oral tablet
    • adverse effect: tardive dyskinesia
  16. mylicon (simethicone)
    • antiflatulent
    • cause N/V/D
    • works best when used after meals & at bedtime
  17. rubella vaccine
    • avoid pregnancy for at least 3 months
    • avoid other vaccines for 1 month b4 & after
    • administer at least 3 months after blood/plasma transfusion, or immune globulin
  18. percocet
    • opioid/acetaminophen combination
    • avoid sudden discontinuation
    • may cause euphoria, dysphoria
    • report constipation, orthostatic hypotension, excessive sedation, s/s resp. depression
  19. tylenol #3
    • opioid/acetaminophen combination
    • same as percocet
  20. ibuprophen
    • analgesic, NSAID
    • avoid use in late pregnancy 
    • take with food, milk to reduce GI distress
    • no smoking or drinking
  21. benadryl
    • analgesic, antihistamine
    • young children may experience paradoxical effect
    • anticholingeric effect
    • avoid using with MAOI or CNS depressant
    • no ETOH
  22. ampicillin
    • decrease effective of oral contraceptive
    • take with full flass half an hour b4 or 2 hrs after meal
  23. clindamycin
    take with a full glass of water
  24. duramorph
    morphine, analgesic, opioid
  25. lansinoh
    • for sore nipples, dry, cracked skin
    • safe for baby
  26. tucks
    • relieve swelling, bleeding, itching, minor pain, and discomfort caused by minor skin irritations (e.g., cuts, scrapes, insect bites). It is also used to relieve itching, discomfort, irritation, and burning caused by hemorrhoids.
    • cautious during pregnancy, discuss with PCP
    • pass into breast milk
  27. bicitra
    • sodium citrate, citric acid- urinary alkanizer (increase urinary pH to decrease stone-forming salt)
    • limit salt intake
    • high fluid intake
  28. Colace/pericolace
    • laxative, stool softener
    • bitter taste in mouth
    • should not use longer than 1 wk
    • should not take this together with other meds within 2 hrs
    • not with mineral oil

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