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Sim Lab Medications Flashcards

(65 cards)

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1
Q

Uses of pitocin

A

Induction/augmentation of labor
PPH

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2
Q

Route for pitocin used for labor induction/augmentation

A

IV titration

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3
Q

Route used for pitocin for PPH

A

IV bolus
IM injection

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4
Q

Action of pitocin

A

Stimulates uterine smooth muscle, resulting in increased strength, duration, and frequency of contractions
Vasoactive and anti diuretic properties

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5
Q

Side effects of pitocin for mother

A

*Water intoxication
Tachysystole
Impaired uterine blood flow
Fetal asphyxia
Uterine rupture

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6
Q

Side effects of pitocin for fetus

A

Bradycardia
Tachycardia
Reduced variability
Late or prolonged decels

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7
Q

Nursing responsibilities for pitocin given for induction/augmentation

A

Assess contractions and VS every 15 min
Assess FHR before induction and every 15 min during
Monitor for water intoxication
Monitor I&Os

Stop infusion if:
- contractions <2 min apart and >50-65 sec or if they last longer than 60-90 seconds
- fetal distress

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8
Q

Symptoms of water intoxication

A

Drowsiness
Listlessness
Confusion
HA
Anura

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9
Q

Nursing responsibilities for pitocin given PP

A

Monitor uterine height, tone, deviation
Monitor lochia flow
Monitor VS

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10
Q

Patient teaching for pitocin given for induction/augmentation

A

Expect cramping similar to menstrual cramps that gradually increase in intensity and become strong
Report increased abdominal pain, blood loss, or fever

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11
Q

Patient teaching for pitocin given PP

A

Report boggy uterus or increase in lochia flow
Teach pt to massage their fundus

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12
Q

Preferred route for methergine

A

IM for rapid absorption

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13
Q

Use of methergine

A

Treat/prevent PPH (or post abortion hemorrhage) caused by uterine agony or subinvolution

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14
Q

Action of methergine

A

Stimulates sustained contraction of the uterus and causes arterial vasoconstriction

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15
Q

Side effects of methergine

A

*Hypertension
N/V
Uterine cramping
Dyspnea
Dysrhythmias

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16
Q

Nursing responsibilities for methergine

A

Use caution in pts with HTN and cardiac disease
Nicotine causes vasoconstriction and cannot be used with methergine
Monitor BP/VS (*check BP prior to each dose)
Monitor vaginal bleeding, uterine tone, height of fundus

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17
Q

Patient teaching for methergine

A

*Avoid smoking because nicotine constricts vessels
Abdominal cramps are a side effect
Notify prescriber if you have chest pain, N/V, HA, muscle pain, weakness, cold, numb extremities
Teach pt to massage fundus

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18
Q

Route for Hemabate

A

IM

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19
Q

Use of Hemabate

A

to treat PPH

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20
Q

Action of Hemabate

A

Stimulate contraction of the uterus

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21
Q

Maximum dose of methergine

A

Can be given every 2-4 hours for a maximum of 5 doses

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22
Q

Maximum dose of Hemabate

A

May repeat at 15 to 90 min intervals
Maximum total of 2 mg

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23
Q

Side effects of Hemabate

A

*Diarrhea
Titanic contractions and laceration of uterus or uterine rupture
Hypertension/hypotension
Nausea

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24
Q

Nursing responsibilities for Hemabate

A

*Administer anti diarrheal as ordered
*Monitor fundus and lochia
Should be refrigerated
Give via Deep IM injection
Rotate sites if repeated
Monitor vitals
Administer antiemetics as ordered

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25
Patient teaching for Hemabate
Almost always causes diarrhea so we will admin antidiarrheal to avoid Expect abdominal cramps similar to menstrual cramps Change position slowly Report any increase in vaginal bleeding
26
Routes for cytotec
PO PR PV (Rectal preferred for PPH)
27
Uses for cytotec
Cervical ripening Treatment of PPH
28
Action of cytotec
Induces uterine contractions Ripens cervix, making it softer and causes it to begin to dilate and efface
29
Side effects of cytotec
Uterine cramping Tachysystole Uterine rupture Diarrhea Nausea/vomiting Dyspepsia
30
Nursing responsibilities for cytotec
*NOT used in women with previous uterine scar *DO NOT start pitocin for at least 4 hours after vaginal cytotec dose (for induction) Monitor FHR, contraction pattern, cervical dilation/effacement
31
Patient teaching for cytotec
Lie flat for 30 min after insertion of medication (void prior to insertion) Report contractions lasting > 1 min Report any worsening or increase in vaginal bleeding
32
Route for terbutaline
SQ
33
When should terbutaline not be given?
If pulse is > 120 If systolic BP < 80-90 If FHR >180 Don’t use beyond 48-72 hours
34
Use of terbutaline
To stop preterm labor contractions
35
Action of terbutaline
Relaxes uterine smooth muscle by acting on beta2 receptors with less effect on the heart
36
Side effects of terbutaline
*Maternal and fetal tachycardia Dyspnea Palpitations Chest pain/discomfort Restlessness Tremors Flushing Hypokalemia
37
Nursing responsibilities for terbutaline What is the antidote? Which pts should you use caution with?
Monitor VS/HR Ensure inderal is available to reverse adverse effects Caution in women with history of cardiac disease, gestational diabetes, severe gestational HTN, eclampsia Monitor fetus, contraction pattern, dilation/effacement
38
Patient teaching for terbutaline
Inform her that she will hear baby’s HR increase on monitor and that this is expected Limit caffeine Drug is only administered in the hospital Report if symptoms continue once you go home
39
What is the max dose of magnesium sulfate?
24 grams in 24 hours
40
Route for mag sulfate
IV IM (rarely)
41
Use of mag sulfate
Prevent seizures Treatment of preterm labor
42
Action of mag sulfate
Increases osmotic pressure, draws fluid into colon, neutralizes HCL Plays important role in neurotransmission and muscular excitability
43
Side effects of magnesium sulfate on patient
Depression of DTR CNS depression Flushing/sweating Hypotension Respiratory depression
44
Side effects of magnesium sulfate on fetus
Reduced FHR variability Hypotonia
45
Nursing responsibilities for mag sulfate
*Antidote = calcium gluconate (keep in room) Monitor BP closely Assess VS (RR should be > 12) Monitor I&O (UOP should be > 30 mL/hr) Monitor DTRs Assess edema in LE If preeclampsia - seizure precautions Assess magnesium toxicity Monitor Mg and Ca levels (therapeutic mag level: 4.8-8.4)
46
Symptoms of magnesium toxicity
Thirst Confusion Decreased DTR Visual changes: blurring, halos
47
Patient teaching for magnesium sulfate
Med is given to delay preterm labor and prevent seizures associated with eclampsia Need for frequent monitoring Report SE (family or pt) Side rails up OOB with assistance
48
Route for Lebatalol
IV PO IM
49
Use of Lebatalol
Treat HTN during pregnancy hypertensive emergencies Reduces BP associated with preeclampsia/eclampsia and preserves uteroplacental blood flow
50
Action of Lebatalol
Produces decrease in BP without reflex tachycardia or significant reduction in HR through mixture of A and B blocking effects
51
Side effects of Lebatalol
Orthostatic hypotension Flushing Tremulousness Minimal change in pulse rate
52
Nursing responsibilities for Lebatalol Who is it contraindicated for?
Monitor VS Maintain BR in left lateral position with SR up Continuous fetal monitoring Contraindicated in patients with asthma, heart disease, or CHF
53
Patient teaching for Lebatalol
Change positions slowly to prevent orthostatic hypotension Explain need for BR and increased monitoring in labor Explain why receiving medication and potential SE If intrapartum, monitor BP, eat well, keep appointments
54
Route for vitamin k
IM in Vastus lateralis
55
Use for vitamin K
*Prevent hemorrhagic disease of the newborn
56
action of vitamin k
Provides vitamin k which is not synthesized in the intestine until flor is present for vitamin k production
57
Side effects of vitamin k
Pain Edema or erythema at injection site Hyperbilirubinemia Hemolytic anemia Bronchospasm Respiratory arrest
58
Nursing responsibilities for vitamin k
*Give within 2 hours of birth *Give prior to circumcision Protect drug from light until ready to give Observe for signs of bleeding (bruising or bleeding from site, blood in urine/stools)
59
Patient teaching for vitamin k
Report symptoms of bleeding or bruising, blood in urine, or black tarry stools Periodic lab tests to monitor coagulation
60
Dose for erythromycin eye ointment
1 cm ribbon into each conjunctival sac
61
Use for erythromycin eye ointment
*Prophylaxis for gonorrhea in eyes
62
Action of erythromycin eye ointment
Inhibits protein synthesis in bacteria (bacteriostatic)
63
Side effects of erythromycin eye ointment
Temporary blurred vision Chemical conjunctivitis Burning Itching Redness
64
Nursing responsibilities for erythromycin eye ointment
*Apply - inner to outer canthus, may wipe away after 1 minute *Give within 1-2 hours after birth Observe for irritation
65
Patient teaching for erythromycin eye ointment
Med does not need to be rinsed from infant’s eyes Infant’s vision will be blurred while medication is in place Not treating the infant could lead to blindness from infection

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