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Flashcards in Chapter 31 Deck (16):
1

RhoGAM

prevention of anti Rho antibody
best if administered twice @ 28wks and 72hrs post delivery
IM route, never by IV

2

tocolytics

medications that produce uterine relaxation and suppress uterine activity in an attemp to halt uterine contractions and prevent preterm birth

3

tocolytics (kinds)

indomethacin (indocin)
magnesium sulfate
nifedippine (procardia, Adalat, Nifedical)
Terbutaline (Brethine)

4

tocolytics (maternal contraindications)

severe preeclampsia and eclampsia
active vaginal bleeding
intrauterine infection
cardiac disease
medical or obstetric condition that contraindicates continuation of pregnancy

5

tocolytics (fetal contraindications)

gestational age > 37 wks
cervical dilation > 4cm
fetal demise
lethal fetal anomaly
chorioamnionitis
acute fetal distress
chronic intrauterine growth restriction

6

interventions when receiving tocolytic therapy

position client on her side to enhance placental perfusion and reduce pressure on cervix
2 monitor maternal VS, fetal status, and labor status frequently
3 monitor for signs of adverse reactions
4 monitor daily weight and I&Os

7

magnesium sulfate

CNS depressant and anticonvulsant
uses: stops preterm labor
prevents/controls pre/eclamptic seizures

8

magnesium sulfate antidote

calcium gluconate

9

magnesium sulfate adverse rxns

maternal - depressed respirations, depressed DTRs, hypotension, extreme muscle weakness, flushing, decreased urine output, pulmonary edema, serum mag levels > 9 mg/dL
newborn - hypotonia and sleepiness
IV admin should not be used for 2 hrs preceding delivery
monitor DTRs hourly

10

indomethacin (indocin) - tocolytic

prostaglandin inhibitor; relaxes uterine smooth muscle
used when other methods fail ONLY if gestational age <32 wks

11

indomethacin (indocin) adverse effects

maternal - N&V, dyspepsia, dizziness
fetal - premature closure of ductus arteriosus
newborn - bronchopulmonary dysplasia, respiratory distress syn, ICP, necrotizing enterocolitis, hyperbilirubinemia

12

nifedipine (procardia, adalat, nifedical) - tocolytic

calcium channel blocker, relaxes smooth muscles

13

nifedipine (procardia, adalat, nifedical) adverse effects

maternal - tachycardia, hypotension, dizziness, headache, nervousness, facial flushing, fatigue, nausea
newborn - hypotension

14

terbutaline (brethine) - tocolytic

beta adrenergic agonist (relaxes smooth musc) - inhibits uterine activity and causes bronchodilation

15

terbutaline (brethine) adverse effects

maternal - tachycardia, palpitations, pulmonary edema, chest pain, MI, hypotension, tremors, hypokalemia, hyperglycemia
newborn - tachycardia, hypotension, ileus, hypocalcemia, hyperbilirubinemia, hyperinsulinemia w/ hypoglycemia

16

magnesium sulfate contraindications

pts w/ heart block, myocardial damage, or renal failure