Reproductive Flashcards
(38 cards)
Human Chorionic Gonadotropin (hCG) Class/Use
Ovulation stimulant
Promotion of ovulation
* Treatment of infertility in conjunction with drug therapy for follicular maturation
Human Chorionic Gonadotropin (hCG) Adverse Drug Reactions
Ovarian hyperstimulation
* Ovarian cyst rupture
* CNS effects: irritability, headache, fatigue, restlessness
Human Chorionic Gonadotropin (hCG) Interventions
Monitor for indications of ovarian hyperstimulation this syndrome warrants hospitalization and immediate discontinuation of drug therapy.
* Monitor for indications of bleeding into the peritoneum.
* Monitor for CNS effects.
Human Chorionic Gonadotropin (hCG) Administration
Confirm follicular maturation with clomiphene (Clomid), menotropins, or follitropins before administration.
* Give via IM injection after reconstituting powder with the supplied dilu- ent.
Human Chorionic Gonadotropin (hCG) Teaching
Seek medical care immediately for pelvic or low abdominal pain or pressure, unusual weight gain, or swelling.
* Report pelvic or abdominal pain.
* Take over-the-counter analgesics as needed for headache.
Human Chorionic Gonadotropin (hCG) Contraindications
Pituitary tumor
* Dysfunctional uterine bleeding
Human Chorionic Gonadotropin (hCG) Interactions
antidepressants - impairs fertility
Oxytocin Class/Use
Oxytocin
Uterine stimulation
* Induction or enhancement of labor near or post term
* Treatment of postpartum hemorrhage
Oxytocin Adverse Affects
Uterine hyperstimulation
* Hypertensive crisis
Oxytocin Interventions
Monitor risk factors such as multiple deliveries.
* Monitor length, strength, and duration of contractions.
* For indications of hyperstimulation, turn clients on their side, stop the infusion, and administer oxygen.
* Be prepared to administer a uterine relaxant.
* Monitor for headache, nausea, vomiting, and increasing blood pressure.
* Monitor intake and output and level of consciousness.
Oxytocin Administration
Administer IV via infusion pump.
* Gradually increase the flow rate by 1 to 2 milliunits/min every 30 to 60 min until contractions last 1 min or less every 2 to 3 min.
* Monitor blood pressure and pulse rate.
* Monitor for uterine hyperstimulation (contractions lasting longer than 60 seconds, occurring more frequently than every 2 to 3 min, Stop the infusion and report hyperstimulation immediately.
* Monitor fetal heart rate and rhythm, and report signs of fetal distress.
* Stop the infusion for serious alterations in fetal heart rate or rhythm.
Oxytocin Teaching
Report increasing duration or strength of contractions.
* Report headache, palpitations, nausea, or chest pain.
* Report drowsiness or headache
Oxytocin Contraindications
Unripe cervix
* Placental abnormalities
* Active genital herpes
* Uterine surgery
* Fetal distress
* Lung immaturity
* Cephalopelvic disproportion
* Malpresentation
* Prolapsed umbilical cord
Oxytocin Interactions
vasopressors
Oxytocin Precautions
HTN/preeclamsia
multiple fetus
seizures
Magnesium Sulfate Class/Use
Anticonvulsant
Prevent and treat seizure activity in client with severe preeclampsia or eclampsia
Magnesium Sulfate Adverse Drug Reactions
Flushing, diaphoresis
* Drowsiness, muscle weakness
* Maternal hypotension, bradycardia, bradypnea
* Depressed/absent deep tendon reflexes (DTRs)
* Altered level of consciousness
* Decreased urine output
* Magnesium toxicity
* Reduced variability of fetal heart rate
Magnesium Sulfate Interventions
Monitor blood pressure, pulse, and respiratory rate every 15 to 30 min.
* Report respiratory rate of 12/min or less.
* Monitor DTRs every 1 to 4 hr.
* Discontinue infusion and notify provider of diminished or absent reflex.
* Monitor level of consciousness before initiation of medication and throughout therapy.
* Monitor strict input and output, with urinary output hourly.
* Report urine output of less than 25 to 30 mL/hr.
* Output less than 25 mL/hr can warrant discontinuation of treatment.
* Monitor serum magnesium levels (target range 4 to 7 mEq/L).
* Ensure antidote for toxicity, calcium gluconate or calcium chloride, is readily available.
* Monitor breath sounds.
* Report presence of crackles.
* Discontinue infusion and notify provider of findings.
* Monitor fetal heart rate for decreased variability
Magnesium Sulfate Administration
Loading dose of 4 to 6 g magnesium sulfate intermittent IV bolus as a secondary infusion over 15 to 30 min. Use a volumetric pump to ensure accuracy of dose.
* Administer maintenance dose by continuous infusion at 2 g/hr.
* Monitor blood levels to maintain therapeutic level at 4 to 7 mEq/L.
Magnesium Sulfate Teaching
Provide comfort measures.
* Instruct the client to change positions slowly from supine to upright and to sit until dizziness resolves.
* Assist the client as needed to promote safety.
* Explain the purpose of strict measurement of oral intake and urinary output.
Magnesium Sulfate Contraindications
Anuria
* Hypermagnesemia
* Heart block
* Hypocalcemia
Magnesium Sulfate interactions
Ca channel blockers – increases antihypertensive effects
Betamethasone Class/Use
Glucocorticoid
To increase the production of lung surfactant and to accelerate lung maturity in fetuses between 24 and 34 weeks’ gestation
Betamethasone Adverse Drug Reaction
Pulmonary edema if given with beta blockers
hyperglycemia if gestational DM
hypertension
