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Flashcards in Week 2 Deck (30)
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1

Ibuprofen: trade name

Motrin

2

Ibuprofen: indications

  • afterpains
  • perineal pain

3

Ibuprofen: dosage

  • as an analgesic: 200–400 mg q 4–6 hr (not to exceed 1200 mg/day)
  • as an anti-inflammatory: 400–800 mg 3–4 times daily (not to exceed 3200 mg/day)

4

Ibuprofen: ADRs

  • HA
  • dizziness
  • constipation
  • dyspepsia
  • nausea
  • GI bleeding
  • anaphylaxis

5

Ibuprofen: nursing implications

  • encourage mother to take on regular schedule to stay ahead of both perineal and analgesic discomfort
  • take w/ full glass of water
  • assess pain
  • monitor for S/S of GI bleed

6

Oxycodone w/ acetaminophen: trade name

Percocet

7

Oxycodone w/ acetaminophen: indications

  • postpartum perineal pain and afterpains

8

oxycodone w/ acetaminophen: dosage

  • 0.2 mg/kg q 3–4 hr initially, as needed (oxycodone)
  • 325–650 mg q 6 hr (acetaminophen)
    • do not exceed 4g of acetaminophen/day

9

oxycodone w/ acetaminophen: ADRs

  • orthostatic hypoTN
  • confusion
  • sedation
  • constipation
  • HA
  • dry mouth
  • n/v
  • respiratory depression
  • atelectasis

10

oxycodone w/ acetaminophen: nursing implications

  • teach pt about potential for abuse/opiate dependence
  • teach pt not to exceed 4g/day of acetaminophen
  • advise pt to make position changes slowly
  • do not drink alcohol
  • turn, cough, deep breathe to prevent atelectasis
  • assess BP, pulse, respirations
  • assess pain
  • assess bowel function routinely

11

morphine sulfate (long acting): trade name

Duramorph

12

morphine sulfate (long acting): indications

  • postpartum CS pain

13

morphine sulfate (long acting): dosage

  • epidural: 
    • intermittently: 5 mg/day (initially); if relief is not obtained at 60 min, 1–2 mg increments may be made
      • (total dose not to exceed 10 mg/day.)
  • IV: 4–10 mg q 3–4 hr

14

morphine sulfate (long acting): ADRs

  • itching
  • nausea
  • confusion
  • sedation
  • respiratory depression
  • hypoTN
  • constipation
  • flushing

15

morphine sulfate (long acting): nursing implications

  • administer immediately after CS via epidural to give pain relief for 18-24 hours
  • change positions slowly
  • no alcohol use
  • emphasize importance of constipation prevention: fluids, walking, fiber
  • assess bowel function routinely
  • d/c gradually
  • monitor RR, breath sounds
  • assess pain

16

Ketorolac: trade name

Toradol

17

Ketorolac: indications

  • postpartum CS pain management

18

Ketorolac: dosage

  • PO: 20 mg initially, followed by 10 mg q 4–6 hr (not to exceed 40 mg/day).
  • IM: 
    • Single dose– 60 mg. 
    • Multiple dosing– 30 mg q 6 hr (not to exceed 120 mg/day).
  • IV: same as IM

19

Ketorolac: ADRs

  • drowsiness
  • dizziness
  • n/v
  • itching
  • GI bleed
  • injection site pain
  • prolonged bleeding time

20

ketorolac: nursing implications

  • avoid using alcohol, NSAIDs, acetaminophen
  • should always give initially as IM/IV
  • administer IVPB over 15 sec
  • assess pain

21

Naloxone: trade name

Narcan

22

Naloxone: indications

  • severe respiratory depression in the newborn when the mother has received narcotics w/in 4 hours of delivery

23

Naloxone: dosage

  • neonates: 0.1 mg/kg
    • can give IM, IV, subQ
      • IV is preferred during resuscitation
      • IM is acceptable but may have delayed onset

24

Naloxone: ADRs

  • if mother was addicted to opiates, do not give
    • may cause withdrawal and seizures
  • n/v 
  • ventricular arrhythmias

25

Naloxone: nursing implications

  • note strength of med available when calculating dose
  • when depression from opiates is expected, prepare syringe before birth by drawing up more than is needed
    • after birth, calc amt needed for infant's weight
    • excess is removed from syringe and correct dose given
  • monitor for response, and be prepared to give repeated doses

26

Simethicone: trade name

Mylicon

27

Simethicone: indications

  • Relief of painful symptoms of excess gas in the GI tract that may occur CS

28

Simethicone: dosage

  • 40–125 mg qid, after meals and at bedtime
    • (up to 500 mg/day).

29

Simethicone: ADRs

None significant!

30

Simethicone: nursing implications

  • Assess patient for abdominal pain, distention, and bowel sounds prior to and periodically throughout course of therapy.
    • Frequency of belching and passage of flatus should also be assessed
  • administer after meals and at bedtime for best results