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Pharmacology > ATI section 13: Médications for the Reproductive System > Flashcards

ATI section 13: Médications for the Reproductive System Flashcards

1
Q

Consider the following when providing client education and support regarding contraception

A
  • Age and health status, including risk for STI
  • Religion and culture
  • Plans for future conception
  • Frequency of intercourse
  • Number of sexual partners
  • Personal concerns about availability, spontaneity, ease of use
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2
Q

Ortho Evra

A
  • Contraceptive patch
  • Replace patch every 3 weeks
  • Apply patch to buttocks, abdomen, upper torso, upper/outer arm
  • period week 4
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3
Q

Depo-Provera

A
  • Injection administered every 3 months during menstrual cycle
  • use backup form of BC for 7 days after unprotected sex
  • Fertility returns 1 yr after stopping
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4
Q

Emergency contraceptive

A
  • Larger than normal dose of oral contraceptive
  • Taken no longer than 72 hrs after unprotected sex
  • 2nd dose repeated 12hr later
  • Antiemetics may be needed
  • Never use as primary method of BC
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5
Q

Nuva Ring

A
  • Placed deep into the vagina once every 3 weeks
  • One size fits most women
  • If it falls out, rinse with warm water and return within 5 hr
  • Remove ring during week 4, menses begins
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6
Q

Intrauterine device (IUD)

A
  • Contraindicated with diabetes or PID
  • High risk for infection
  • May have cramping and heavier periods
  • Hormonal effective up to 7 yrs
  • Copper effective up to 12 yrs
  • Monitor for signs of infection
  • Verify string is present
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7
Q

Cervical cap

A
  • Use with spermicide
  • Fitted by prescriber
  • Pap every 3 months
  • Increased risk of vaginal infection
  • Leave in place 6 hr after intercourse but not longer than 48 hrs
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8
Q

Cevical diaphragm

A
  • Use with spermicide
  • Fitted by prescriber
  • Refitted after childbirth or weight gain/loss
  • Leave in place 6 hr after intercourse
  • Refit size with 10lb or more weight change
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9
Q

Condom

A
  • Use with spermicide
  • Protects against STDs
  • Apply and remove correctly
  • Use only water-soluble lubricants
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10
Q

Spermicides

A
  • Available as: cream, foam, gel, suppository, film
  • Should be used with barrier method
  • Can insert up to 1 hr before intercourse
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11
Q

Nursing Interventions and Client Education

A
  • Discuss conception and contraceptive plans with client to include reliability, benefits, and risks
  • instruct client to maintain regular health screening visits
  • Instruct client about measures to prevent PID, STIs
  • Explain that contraceptive decisions may change over the life span
  • Teach clients unreliable forms of BC including withdrawal, douching, and breastfeeding
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12
Q

Oxytocic

A
  • Cervical Ripening
  • Cervidil (Cervical gel)

Precautions/Interactions:

  • genital herpes
  • ruptured membranes
  • placenta previa

Side/Adverse Effects:

  • N/V
  • Stomach/back pain
  • Feeling of warmth in the vaginal area

Nursing Interventions and Client Education:

  • Bed rest for 1-2 hr after insertion
  • Record maternal vitals and fetal HR
  • Monitor uterine contractions
  • Remove by gently pulling the netted string and discard
  • Oxytocin augmentation may be initiated as needed
  • Assess Bishop score for 6 and greater to begin induction
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13
Q

Oxytocin (Pitocin)

A

Therapeutic Use

  • Antepartum for contraction stress test (CST)
  • Intrapartum for induction or augmentation of labor
  • Postpartum to promote uterine involution

Precautions/Interactions

  • Placental insufficiency
  • Bishop score of 6 and greater when planning induction

Side/Adverse Effects:

  • Intense uterine contractions
  • Uterine hyperstimulation (contraction longer than 90 seconds)
  • Uterine rupture

Nursing Interventions and Client Education:

  • Administer secondary infusion via infusion pump for induction or augmentation
  • Continuously monitor uterine contractions and fetal HR
  • Discontinue oxytocin with any signs of uterine hyperstimulation
  • Administer oxygen via face mask 10L for signs of hyper stimulation
  • When used in postpartum, monitor client for signs of uterine bleeding
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14
Q

Methylergonovine (Methergine)

A

Therapeutic Use
-Postpartum hemorrhage

Precautions/Interactions
-Extreme caution with: hypertension, preeclampsia, heart disease, venoatrial shunts, mitral valve stenosis, sepsis, or hepatic or renal impairment

Side/Adverse Effects:

  • Potent vasoconstriction
  • Hypertension
  • headache

Nursing Interventions and Client Education:

  • Continuously monitor BP
  • Assess uterine bleeding and uterine tone
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15
Q

Tocolytics

A

-Act on uterine muscle to cease contractions

Therapeutic Use
-Stop preterm labor

Medications:

  • Terbutaline, ritodrine
  • Nifedipine
  • Magnesium sulfate
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16
Q

Terbutaline sulfate, ritodrine HCI

A

Side/Adverse Effects:

  • Nervousness
  • N/V
  • Severe palpitations
  • Chest pain
  • Pulmonary edema

Nursing Interventions:

  • Monitor contractions and FHT
  • Monitor vitals
  • Do not administer if pulse rate greater than 130/min or client has chest pain

Beta Blocking agent is antidote

17
Q

Nifedipine

A

Side/Adverse Effects:

  • Hypotension
  • Fatigue
  • Flushing
  • Uteroplacental perfusion complications

Nursing Interventions:

  • Monitor BP
  • Avoid concurrent use with magnesium sulfate
  • Monitor contractions and FHT
  • Prevent complications with hypotension
18
Q

Magnesium sulfate

A

Side/Adverse Effects

  • Warmth
  • Flushing
  • Respiratory depression
  • Decreased urine output
  • Pulmonary edema

Nursing Interventions

  • Monitor vitals and DTRs
  • Monitor magnesium levels (therapeutic range 4-8mg/dL)
  • Administer via infusion pump in diluted form
  • Use indwelling catheter to monitor urinary elimination

Administer calcium gluconate 10% if available for signs of toxicity

19
Q

Antenatal steroids

Betamethasone (Celestone)

A

Therapeutic Use:
-Promote fetal lung maturity in preterm labor when delivery is likely

Side/Adverse Effects:

  • Fluid retention
  • Elevated BP

Nursing Interventions and Client Education:

  • Administer 2 doses (usually IM) 24 hr apart (repeat doses not recommended)
  • Provide emotional support to the family
20
Q

Rho(D) Immune Globulin (RhoGAM)

A

Therapeutic Use:
-Rh factor incompatibility to prevent sensitization for subsequent pregnancies

Precautions:

  • Confirm the mother is Rh-negative
  • Never administer the IGIM full-dose or microdose products IV
  • Never administer to a neonate

Nursing Interventions and Client Education:
-RhoGAM is administered as an injection after any event where fetal cells can mix with maternal blood

Pharmacology (18 decks)

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