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NCLEX > Reproductive Medications > Flashcards

Reproductive Medications Flashcards

1
Q

Oral contraceptives considerations (2)

A
  • Pill taken daily
  • Adverse effects: breast tenderness, bleeding, n/v
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2
Q

Oral contraceptives education (2)

A
  • Antibiotics, rifampin, phenytoin reduce effectiveness
  • Don’t smoke
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3
Q

Ethinyl estradiol/norelgestromin (patch) consideration

A

Replace patch each week for 3 weeks

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4
Q

Ethinyl estradiol/norelgestromin (patch) education (2)

A
  • Apply patch to butt, abdomen, upper torso, upper/outer arm
  • Period starts on 4th week with no patch
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5
Q

Medroxyprogesterone consideration

A
  • Injection given every 3 months during period
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6
Q

Medroxyprogesterone education (2)

A
  • Use backup contraception for 7 days after first injection
  • Fertility returns 1 year after stopping
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7
Q

Emergency contraception considerations (4)

A
  • Larger than normal dose of oral contraceptives
  • Take no later than 72 hours after unprotected sex
  • 2nd dose 12 hours later
  • May need antiemetics
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8
Q

Emergency contraception education (2)

A
  • Discuss options with provider
  • Don’t use as primary form of contraception
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9
Q

Etonogestrel, ethinyl estradiol vaginal ring considerations

A
  • Placed deep into the vagina every 3 weeks
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10
Q

Etonogestrel, ethinyl estradiol vaginal ring education (3)

A
  • One size fits most
  • If it falls out rinse in warm water and replace within 3 hours
  • Remove ring during week 4 and period should start
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11
Q

Intrauterine device (IUD) considerations (3)

A
  • Not for women with diabetes, history of PID
  • Risk of infection
  • Can have cramping and heavier periods
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12
Q

IUD education (4)

A
  • Hormonal IUD effective for up to 5 years
  • Copper IUD effective for up to 10 years
  • Monitor for signs of infection
  • Verify string is present
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13
Q

Cervical diaphragm considerations (3)

A
  • Use with spermicide
  • Fitted by prescriber
  • Refitted after birth or changes in weight
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14
Q

Cervical diaphragm education (2)

A
  • Insert 6 hours before and 6 hours after sex
  • Refit with 10 lb weight change or after birth
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15
Q

Condom considerations

A
  • Use with spermicide
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16
Q

Condom education (3)

A
  • Protects against STIs
  • Apply/remove correctly
  • Use only water-soluble lubricants
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17
Q

Spermicide considerations

A
  • Available in creams, foams, gels, suppositories, films
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18
Q

Spermicide education (2)

A
  • Should also use barrier method
  • Insert up to 1 hour before sex
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19
Q

Cervical ripening medication action

A

Prostaglandins cause cervical softening in preparation for cervical dilation and effacement

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20
Q

Cervical ripening medications (2)

A
  • Dinoprostone cervical gel
  • Misoprostol
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21
Q

Cervical ripening medication precaution

A
  • Contraindicated in patients with acute PID, history of pelvic surgery, abnormal fetal position
22
Q

Cervical ripening medication side/adverse effects (5)

A
  • Nausea
  • Headache
  • Tremors, tension
  • Feeling of warmth in vaginal area
  • Elevated temperature
23
Q

Cervical ripening medication nursing interventions (4)

A
  • Keep patient on bedrest for at least 2hours (30 minutes for gel) after insertion
  • Monitor/record maternal vitals, fetal heart rate, uterine contractions
  • Oxytocin may be needed
  • Major adverse effect is tachysystole
24
Q

Oxytocin action

A

Stimulates uterine contractions for inducing labor and prevents postpartum hemorrhage

25
Q

Oxytocin use (3)

A
  • Antepartum for contraction stress test
  • Intrapartum for induction/augmentation of labor
  • Postpartum to promote uterine tone
26
Q

Oxytocin precautions (2)

A
  • Contraindicated with placental abnormalities, fetal malpresentation, previous uterine surgery, fetal distress
  • Bishop score of 6 or greater when planning induction
27
Q

Oxytocin side/adverse effects (4)

A
  • Intense uterine contractions
  • Uterine hyper stimulation
  • Uterine rupture
  • Water intoxication
28
Q

Oxytocin nursing interventions (5)

A
  • Give as secondary infusion through pump for induction/augmentation
  • Continuously monitor contractions, fetal heart rate
  • Stop if any signs of uterine hyper stimulation, maternal/fetal distress
  • Oxygen by face mask 10L for signs of hyper stimulation
  • For postpartum use monitor for uterine bleeding
29
Q

Methylergonovine action

A

Acts directly on the uterine muscle to stimulate forceful contractions

30
Q

Methylergonovine use

A

Postpartum hemorrhage

31
Q

Methylergonovine precautions

A
  • Use extreme caution in patients with HTN, preeclampsia, heart disease, venoatrial shunts, mitral valve stenosis, sepsis, cardiovascular/hepatic/renal impairment
32
Q

Methylergonovine side/adverse effects (3)

A
  • Potent vasoconstriction
  • HTN
  • Headache
33
Q

Methylergonovine nursing interventions (2)

A
  • Continuously monitor bp
  • Assess uterine bleeding and tone
34
Q

Tocolytic action

A

Act on uterine muscle to stop contractions

35
Q

Tocolytic medication use

A
  • Stop preterm labor
36
Q

Tocolytic medications (3)

A
  • Terbutaline sulfate
  • Nifedipine
  • Magnesium sulfate
37
Q

Terbutaline side/adverse effects (9)

A
  • Nervousness
  • Tremors
  • Headache
  • N/V
  • Hyperglycemia
  • Severe palpitations
  • Chest pain
  • Pulmonary edema
38
Q

Terbutaline nursing interventions (4)

A
  • Monitor contractions, FHT
  • Monitor vitals
  • Don’t give if pulse is greater than 130/min or patient has chest pain
  • Give beta blocker as antidote
39
Q

Nifedipine side/adverse effects (4)

A
  • Hypotension
  • Headache
  • Nausea
  • Flushing
40
Q

Nifedipine nursing interventions (4)

A
  • Monitor bp
  • Avoid using with magnesium sulfate
  • Monitor contractions, FHT
  • Prevent complications with hypotension
41
Q

Magnesium sulfate side/adverse effects (6)

A
  • Warmth
  • Flushing
  • Respiratory depression
  • Diminished DTRs
  • Decreased urine output
  • Pulmonary edema
42
Q

Magnesium sulfate nursing interventions (4)

A
  • Monitor vitals, DTRs
  • Monitor magnesium levels
  • Give through infusion pump in diluted form
  • Use indwelling catheter to monitor urinary output
43
Q

Betamethasone action

A

Stimulates production of surfactant in fetus between 24-34 weeks gestation

44
Q

Betamethasone use

A
  • Promote fetal lung maturity in preterm labor when delivery is likely
45
Q

Betamethasone side/adverse effects (3)

A
  • Fluid retention
  • Elevated bp
  • Maternal hyperglycemia and transient increase in WBC
46
Q

Betamethasone nursing interventions (2)

A
  • Give 2 doses IM 24 hours apart
  • Emotional support to family
47
Q

Rho(d) immune globulin (rhogam) action

A

Suppresses the stimulation of active immunity by Rh positive foreign blood cells that enter the maternal circulation at the time of delivery

48
Q

Rhogam use

A

Rh factor incompatibility to prevent sensitization for future pregnancies

49
Q

Rhogam precautions (3)

A
  • Confirm mom is Rh negative
  • Don’t give full dose/microdose IV
  • Don’t give to baby
50
Q

Rhogam nursing interventions (2)

A
  • Given within 72 hours after birth if woman is Rh negative and the baby is Rh positive and coombs test is negative
  • Prophylactic injection at 28 weeks and if fetal cells can mix with maternal blood (miscarriage, ectopic pregnancy, induced abortion, amniocentesis, chorionic villus sampling, abdominal trauma)
51
Q

Varicella vaccine during pregnancy

A
  • Should be given to women not vaccinated during postpartum period
  • Use reliable contraception and avoid pregnancy for 3 months after vaccine

NCLEX (40 decks)

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