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pharm III > exam 2: OB + Newborn > Flashcards

exam 2: OB + Newborn Flashcards

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
Q

dinoprostone (prepidil, cervidil) indication

A

induction of labor

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26
Q

dinoprostone (cervidil, prepidil) side effects

A
  • GI distress
  • back pain
  • hyperstimulation (FHR changes)
  • anaphylaxis
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27
Q

nursing considerations for dinoprostone (cervidil, prepidil)

A
  • 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
Q

misoprostol (cytotec) indication

A
  • induction of labor (not approved by FDA for induction)
  • may be used to control PP bleeding
29
Q

side effects for misoprostol (cytotec)

A
  • cramping
  • vaginal bleeding
  • uterine rupture
30
Q

nursing considerations for misoprostol (cytotec)

A
  • contraindicated for hx c-section
  • remain recumbent for 30 mins
  • repeat dose Q4-6 as needed
31
Q

oxytocin (pitocin) indication

A

induction of labor (stimulates contractions)

32
Q

oxytocin (pitocin) side effects

A
  • HTN
  • dysrhythmias
  • hyperstimulation (UC >2 mins, >5 UC in 10 mins)
  • tachysystole (>6 UC in 20 mins)
  • uterine rupture
33
Q

oxytocin (pitocin) nursing considerations

A
  • effective contraction pattern (UC Q2-3 mins, duration 50-60 sec, moderate intensity)
  • keep tocolytic and oxygen readily available
34
Q

fetal intolerance to labor interventions

A
  1. stop infusion
  2. place client on left side
  3. administer oxygen
  4. notify HCP
35
Q

terbutaline (brethine) indication

A
  • stop preterm labor
  • asthma
36
Q

terbutaline (brethine) side effects

A
  • tachycardia/palpitations
  • hyperglycemia
  • fetal hypoglycemia
  • hypokalemia
37
Q

terbutaline (brethine) nursing considerations

A
  • contraindications: heart disease, diabetes
  • readily crosses placenta
  • do not used for prolonged tocolysis
38
Q

magnesium sulfate indication

A
  • stop preterm labor
  • lower BP (BP: pregnancy-induced HTN (PIH) and preeclampsia/eclampia)
  • neuroprotection (preterm delivery (<32 weeks))
39
Q

magnesium sulfate side effects

A
  • sluggishness
  • blurred vision
  • hypotension/tachycardia
40
Q

magnesium sulfate nursing considerations

A
  • 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
Q

hydroxyprogesterone (makena) indication

A

prevents contractions

42
Q

hydroxyprogesterone side effects

A
  • injection site reaction
  • blood clots
  • hyper/hypoglycemia
  • anaphylaxis
43
Q

hydroxyprogesterone (makena) nursing considerations

A
  • given with hx preterm delivery
44
Q

betamethasone indication

A

prevents respiratory distress syndrome (RDS) in preterm infant

45
Q

betamethasone side effects

A
  • vertigo
  • arrhythmias
  • HTN
  • increased blood glucose
46
Q

betamethasone nursing considerations

A
  • most effective 24 hours after administration
  • l/s ratio is an indicator of lung maturity
  • contraindicated with pulmonary edema, gestational HTN, PPROM
47
Q

methylergonovine (methergine) indication

A

prevention/treatment of PPH

48
Q

methylergonovine (methergine) side effects

A
  • tinnitus
  • HTN
  • seizure
49
Q

methylergonovine (methergine) nursing considerations

A
  • 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
Q

carboprost (hemabate) indication

A

treatment of PPH d/t uterine atony
used only following delivery of placenta

51
Q

carboprost (hemabate) side effects

A
  • fever
  • cramping
  • bronchospasm
52
Q

carboprost (hemabate) nursing considerations

A
  • contraindicated with asthma, PID, renal or heart disease, hyper/hypotension
  • rotate injection site
53
Q

erythromycin indication

A

prevention of STI-related infection and subsequent blindness

54
Q

erythromycin side effects

A
  • redness
  • blurred vision
55
Q

erythromycin nursing considerations

A
  • 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
Q

aquamephyton (phytonadione) indication

A
  • prevent bleeding
  • treatment of vitamin K deficiency
57
Q

aquamephyton (phytonadione) side effects

A
  • rash
  • hyperbilirubinemia
  • injection site rxn
58
Q

aquamephyton (phytonadione) nursing considerations

A
  • VKDB
  • 0.5-1mg per dose
  • adm within 1 hour of delivery
59
Q

hepatitis B vaccine indication

A

prevention of hepatitis B infection

60
Q

hepatitis B vaccine side effects

A

injection side rxn (pain, erythema, swelling)

61
Q

hepatitis B vaccine nursing considerations

A
  • 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
Q

lidocaine indication

A
  • pain management
  • ventricular arrhythmia
63
Q

lidocaine side effects

A
  • burning
  • hypotension
  • bradycardia
64
Q

lidocaine nursing considerations

A

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
Q

poractant alfa (curosurf) indication

A
  • respiratory distress syndrome (RDS)
  • preterm delivery
66
Q

poractant alfa (curosurf) side effects

A
  • hyperoxia
  • hypocarbia
  • desaturation
  • cyanosis
  • bradycardia
67
Q

poractant alfa (curosurf) nursing considerations

A
  • 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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