Exam 5 - Lec 61 Oxytocin

Question 1

which stage of labor refers to onset of labor to full cervical dilation?

Answer 1

stage 1

Question 2

which stage of labor refers to time from full dilation to delivery?

Answer 2

stage 2

Question 3

which stage of labor refers to time from delivery to infant to delivery of the placenta?

Answer 3

stage 3

Question 4

two options for labor dystocia (abnormally slow or protracted labor)

Answer 4

-operation (C-section)
-IV oxytocin (Pitocin)

Question 5

oxytocin role in stages 2 and 3 of labor

Answer 5

stimulate contractions before onset of labor to achieve a vaginal delivery

Question 6

contraindications for labor induction (6)

Answer 6

-placenta previa
-fetus in sideway position
-previous classical or high-risk C-section
-prior uterine incision (e.g. myomectomy)
-umbilical cord prolapse
-prior uterine rupture

Question 7

IV oxytocin max dose

Answer 7

40 milliunits/min

Question 8

half-life of IV oxytocin

Answer 8

~3 min when infused

Question 9

oxytocin for medical termination is typically used during ___ trimester

Answer 9

2nd

Question 10

oxytocin for medical termination: dose

Answer 10

50 units/500 mL NS over 3 hrs + 1 hr rest; repeat, adding additional 50 units per cycle

Question 11

what is the ISMP?

Answer 11

institute for safe medication practices

Question 12

WHO recommends continued breastfeeding through ___ months or longer

Answer 12

24

Question 13

AAP recommends continued breastfeeding through ___ months, or as long as mutually desired

Answer 13

12

Question 14

what are the 4 ranges for RID (relative infant doses)?

Answer 14

< 2% = minimal transfer to milk
2-5% = small amount of transfer to milk
5-10% = moderate amount of transfer to milk
> 10% = large amount of transfer to milk; risk of effects in infants exists

Question 15

Hale’s lactation risk categories: what do each of them mean?

Answer 15

L1: safest
L2: safer
L3: moderately safe
L4: possibly hazardous
L5: contraindicated

Question 16

examples of L1 lactation risk drugs (2)

Answer 16

acetaminophen
amoxicillin

Question 17

examples of L2 lactation risk drugs (2)

Answer 17

diphenhydramine
fluoxetine

Question 18

examples of L3 lactation risk drugs (2)

Answer 18

pseudoephedrine
hydrocodone

Question 19

examples of L4 lactation risk drugs (2)

Answer 19

colchicine
dapsone

Question 20

examples of L5 lactation risk drugs (2)

Answer 20

amiodarone
chemotherapy agents

Question 21

methadone and buprenorphine infant risks in lactation (3)

Answer 21

lethargy
respiratory difficulty
poor weight gain

Question 22

true or false: the academy of Breastfeeding Medicine encourages breastfeeding if enrolled in methadone-maintenance program

Answer 22

true

Question 23

maternal risk of buprenorphine in lactation

Answer 23

decreased milk production

Question 24

true or false: you can breastfeed while on disulfiram & naltrexone

Answer 24

false

(use discouraged by FDA labeling)

Question 25

true or false: opioids such as morphine, codeine, hydrocodone, fentanyl and hydromorphone should not be used when lactating

Answer 25

false

(moderately safe; morphine preferred)

Question 26

herbal supplements that increase milk supply (3)

Answer 26

fenugreek
blessed thistle
fennel seed

Question 27

5 things to increase milk supply (slide 35)

Answer 27

-herbal supplements
-oatmeal
-Brewer’s yeast
-metoclopramide
-pumping

Question 28

what time of day does a breast pump get the greatest milk supply?

Answer 28

first thing in the morning