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pharm III > exam 2: OB + Newborn > Flashcards

exam 2: OB + Newborn Flashcards

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1
Q

ethinyl estradiol and norethindrone therapeutic effect

A
  • prevention of pregnancy
  • dysmenorrhea
  • acne
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2
Q

side effects of ethinyl estradiol and norethindrone

A
  • n/v
  • weight gain/bloating
  • breast tenderness
  • chloasma
  • depression
  • h/a
  • HTN
  • blood clots
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3
Q

nursing considerations for ethinyl estradiol and norethindrone

A
  • may alter blood glucose levels
  • contraindicated in pts over 35 yrs and breastfeeding pts
    does not protect against STIs
  • reduced risk of PID, endometrial + cervical cancer, death associated with colorectal cancer
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4
Q

progestin (“mini pill”) indication

A

prevention of pregnancy

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5
Q

sides effects of progestin (“mini pill”)

A
  • irregular bleeding
  • depression
  • mood changes
  • decreased libido
  • fatigue
  • weight gain
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6
Q

progestin (“mini pill”) nursing considerations

A
  • preferred option for clients who have a hx VTE, heart disease/HTN, are breastfeeding, are 35 yrs and older, smoke
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7
Q

doxycycline (vibramycin) indication

A

treatment/prevention of Chlamydia

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8
Q

side effects of doxycycline (vibramycin)

A
  • urticaria
  • photosensitivity
  • nephrotoxicity
  • hepatotoxicity
  • anaphylaxis
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9
Q

nursing considerations for doxycycline (vibramycin)

A
  • do not use if pregnant or breastfeeding
  • avoid in 2nd and 3rd trimester of pregnancy (may impact coloration or teeth and bone growth)
  • take on empty stomach
  • report rash/signs of bleeding
  • monitor for superinfection
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10
Q

metronidazole (flagyl) indication

A

treatment/prevention of trichomoniasis

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11
Q

side effects of metronidazole (flagyl)

A
  • peripheral neuropathy
  • discolored urine
  • metallic taste
  • anaphylaxis
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12
Q

metronidazole (flagyl) nursing considerations

A
  • avoid alcohol
  • do not use if pregnant or breastfeeding
  • increased risk for secondary malignancy
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13
Q

penicillin-G indication

A

treatment/prevention of Syphilis/GBS

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14
Q

side effects for penicillin-G

A
  • colitis
  • vaginitis
  • moniliasis
  • injection site rxn (pain, tenderness, fever)
  • anaphylaxis
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15
Q

nursing considerations for penicillin-G

A
  • avoid use during pregnancy or if breastfeeding
  • report GI symptom changes
  • do not give penicillin-G benzathine via IV
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16
Q

acyclovir indication

A

treatment of HSV

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17
Q

side effects for acyclovir

A
  • gingival hyperplasia (requires regular dental care)
  • rash/pruritus
  • phlebitis
  • mouth pain
  • hepatic and renal toxicity
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18
Q

acyclovir nursing considerations

A
  • not curative
  • treatment takes 7-10 days (may extend to 21 + days)
  • treatment should be initiated within 1 day of outbreak
  • avoid during pregnancy/breastfeeding
  • minimize contact with lesions
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19
Q

folic acid indication

A

prevention of neural tube defects

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20
Q

side effects for folic acid

A
  • flushing
  • malaise
  • erythema
  • pruritus
  • rash
  • bronchospasm
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21
Q

nursing considerations for folic acid

A
  • deficiency contributes to premature birth, low birth weight, and placental abruption
  • may change urine color (deep yellow)
  • encourage intake of folate-rich foods (strawberries, oranges, asparagus, dark green leafy vegetables, bread, rice, pasta, cereal (enriched))
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22
Q

rho (D) immune globulin (rhogam) indication

A
  • prevent the sensitization (isoimmunization)
  • administered to rh-negative mothers
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23
Q

side effects of rhogam

A
  • hypotension
  • rash/pruritus
  • gi upset
  • injection site reaction
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24
Q

nursing considerations for rhogam

A
  • adm to mother (26-28 weeks gestation, within 72 hours of delivery; any time mixing of blood may occur (trauma, miscarriage, amniocentesis))
  • report signs of hemolytic rxn (chills, back pain, dark urine, edema, SOB)
  • risk of hemolysis
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25
dinoprostone (prepidil, cervidil) indication
induction of labor
26
dinoprostone (cervidil, prepidil) side effects
- GI distress - back pain - hyperstimulation (FHR changes) - anaphylaxis
27
nursing considerations for dinoprostone (cervidil, prepidil)
- remain recumbent for at least 2 hours - med is frozen = warm to room temp before insertion - insert remains in place for up to 12 hours
28
misoprostol (cytotec) indication
- induction of labor (not approved by FDA for induction) - may be used to control PP bleeding
29
side effects for misoprostol (cytotec)
- cramping - vaginal bleeding - uterine rupture
30
nursing considerations for misoprostol (cytotec)
- contraindicated for hx c-section - remain recumbent for 30 mins - repeat dose Q4-6 as needed
31
oxytocin (pitocin) indication
induction of labor (stimulates contractions)
32
oxytocin (pitocin) side effects
- HTN - dysrhythmias - hyperstimulation (UC >2 mins, >5 UC in 10 mins) - tachysystole (>6 UC in 20 mins) - uterine rupture
33
oxytocin (pitocin) nursing considerations
- effective contraction pattern (UC Q2-3 mins, duration 50-60 sec, moderate intensity) - keep tocolytic and oxygen readily available
34
fetal intolerance to labor interventions
1. stop infusion 2. place client on left side 3. administer oxygen 4. notify HCP
35
terbutaline (brethine) indication
- stop preterm labor - asthma
36
terbutaline (brethine) side effects
- tachycardia/palpitations - hyperglycemia - fetal hypoglycemia - hypokalemia
37
terbutaline (brethine) nursing considerations
- contraindications: heart disease, diabetes - readily crosses placenta - do not used for prolonged tocolysis
38
magnesium sulfate indication
- stop preterm labor - lower BP (BP: pregnancy-induced HTN (PIH) and preeclampsia/eclampia) - neuroprotection (preterm delivery (<32 weeks))
39
magnesium sulfate side effects
- sluggishness - blurred vision - hypotension/tachycardia
40
magnesium sulfate nursing considerations
- readily crosses placenta (neonate should be monitored for increased magnesium) - monitor for s/s of mag. toxicity (depressed DTRs, lowered RR and HR) - antidote = calcium gluconate
41
hydroxyprogesterone (makena) indication
prevents contractions
42
hydroxyprogesterone side effects
- injection site reaction - blood clots - hyper/hypoglycemia - anaphylaxis
43
hydroxyprogesterone (makena) nursing considerations
- given with hx preterm delivery
44
betamethasone indication
prevents respiratory distress syndrome (RDS) in preterm infant
45
betamethasone side effects
- vertigo - arrhythmias - HTN - increased blood glucose
46
betamethasone nursing considerations
- most effective 24 hours after administration - l/s ratio is an indicator of lung maturity - contraindicated with pulmonary edema, gestational HTN, PPROM
47
methylergonovine (methergine) indication
prevention/treatment of PPH
48
methylergonovine (methergine) side effects
- tinnitus - HTN - seizure
49
methylergonovine (methergine) nursing considerations
- contraindicated with HTN, PVD, CAD - do not adm with other ergot alkaloids or beta-blockers - monitor for ergot toxicity (pain in arms, legs, lower back, numbness, cold hands/feet, weakness, hallucinations) - do not adm IV
50
carboprost (hemabate) indication
treatment of PPH d/t uterine atony used only following delivery of placenta
51
carboprost (hemabate) side effects
- fever - cramping - bronchospasm
52
carboprost (hemabate) nursing considerations
- contraindicated with asthma, PID, renal or heart disease, hyper/hypotension - rotate injection site
53
erythromycin indication
prevention of STI-related infection and subsequent blindness
54
erythromycin side effects
- redness - blurred vision
55
erythromycin nursing considerations
- chlamydia and gonorrhea = most common (damage to cornea) - adm within 1 hour of delivery (delayed to promote bonding) - apply to lower conjunctival sac - wash hands/wear gloves with adm
56
aquamephyton (phytonadione) indication
- prevent bleeding - treatment of vitamin K deficiency
57
aquamephyton (phytonadione) side effects
- rash - hyperbilirubinemia - injection site rxn
58
aquamephyton (phytonadione) nursing considerations
- VKDB - 0.5-1mg per dose - adm within 1 hour of delivery
59
hepatitis B vaccine indication
prevention of hepatitis B infection
60
hepatitis B vaccine side effects
injection side rxn (pain, erythema, swelling)
61
hepatitis B vaccine nursing considerations
- HBIG (hepatitis B immune globulin) ^given if mom is hep B positive or unknown; hep b vaccine can be given concurrently - adm into vastus lateralis - requires parental consent - three-dose series
62
lidocaine indication
- pain management - ventricular arrhythmia
63
lidocaine side effects
- burning - hypotension - bradycardia
64
lidocaine nursing considerations
maternal use: - injected into skin, muscle, or cervix - FHR monitoring - lidocaine spray = used for PP discomfort neonatal use: - dorsal penile nerve block (DPNB) - provide oral sucrose prior to local injection - EMLA cream (lidocaine/prilocaine) applied at least 60 mins before procedure
65
poractant alfa (curosurf) indication
- respiratory distress syndrome (RDS) - preterm delivery
66
poractant alfa (curosurf) side effects
- hyperoxia - hypocarbia - desaturation - cyanosis - bradycardia
67
poractant alfa (curosurf) nursing considerations
- reduces surface tension of alveoli (increases residual air + keeps expanded) - beractant (survanta) (can be used prophylactically, 1/4 per each lung quadrant) - monitor ABG and ventilator settings (requires RN, RT, and provider guidance) - do not suction ET tube - requires ET tube administration

pharm III (6 decks)

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