NCLEX-PN Pharmacology Maternity & Newborn

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Oxytocin (Pitocin)

Action:

Stimulates the smooth muscle of the uterus and induces contraction of myocardium
Oxytocin (Pitocin)

ADR:
- dysrhytmias
- changes in BP
- uterin rupture
- water intoxication
- high doses; hopotension w/ rebound hypertension
Oxytocin (Pitocin)

Interventions:
- If uterine hyperstimulation or nonreassuring FHR occurs:
- medication is stopped
- turn client on her side
- O₂ vis face mask
- notify RN
Ergot Alkaloids

Drug names:
- Ergonovine (Ergotrate)
- Methylergonovine (Methergine)
Ergot Alkaloids

Action:
- directly stimulate uterine muscle
- increase the force & frequency of contractions
- produce arterial vasoconstriction
- vasospasm of the coronary arteries
Ergot Alkaloids

ADR:
- nausea
- uterine cramping
- bradycardia
- dysrhythmias
- MI
- severe hypertension
Ergot Alkaloids

Contraindication:
- pregnancy
- clients with significant cardiovascular disease,
- peripheral vascular disease
- hypertension
- eclampsia
- preeclampsia
Prostaglandins

Actions:

potent stimulators of the myometrium
Prostaglandins

Drug names:
- Carboprost (Hemabate)
- Dinoprostone (Cervidil)
Prostaglandins

ADR:
- diarrhea
- nausea
- vomiting
- stomach cramps
- fever
- chills
- flushing
- dysrhythmias
- bronchoconstriction
- chest pain
- hypertension
- peripheral vasoconstriction
- uterine cramping & tetany
Prostaglandins

Interventions:
- remain with client 30 min after administration
- maintain client in a supine position for 30 min after administration
Magnesium sulfate

Action:
- CNS depressant and anticonvulsant
- causes smooth muscle relaxation
Magnesium sulfate

Antidote:

Calcium gluconate
Magnesium sulfate

ADR:
- reduced respiratory rate
- decreased relflexes
- flushing
- hypotension
- decreased hear rate
- loss of deep tendon reflexes
- heart block
- respiratory paralysis
- cardiac arrest
Magnesium sulfate

Contraindication:
- heart block
- myocardial damage
- renal failure
Magnesium sulfate

Interventions:
- monitor v/s; especially RR every 30 - 60 min
- notify RN if RR below 12/min
- monitor renal and cardiac function
- monitor magnesium levels
- keep calcium gluconate on hand
- deep tendon reflexes monitored hourly
- patellar reflex tested before administering repeat parenteral dose
- patellar reflex must be present and RR must be above 16/min before each parenteral dose
- monitor i/o hourly; output should be maintained at 30mL/hr
Meperidine hydrochloride (Demerol)

Action:

Narcotic analgesic
Meperidine hydrochloride (Demerol)

Antidote:

Naloxone (Narcan)
Meperidine hydrochloride (Demerol)

ADR:
- dizziness
- nausea
- vomiting
- sedation
- decreased BP
- decreased RR
- diaphoreses
- flushed face
- decreased urination
- RR depression
- skeletal muscle flaccidity
- cold, clammy skin
- cyanosis
- extreme somnolence progressing to convulsions, stupor, and coma
Administered with promethazine (Phenergan) to prevent nausea
Meperidine hydrochloride (Demerol)

Interventions:
- monitor v/s; RR under 12/min notify RN
- monitor BP changes
- have antidote ready
Rh_o(D) Immune Globulin (RhoGAM)

Action:

Prevention of anti-Rh(D) antibody formation
Rho(D) Immune Globulin (RhoGAM)

ADR:
- elevated temp
- tenderness at the injection site
Rho(D) Immune Globulin (RhoGAM)

Intervention:
- administered to mother at 28 week gestation and within 72 hours after delivery
- monitor temp
- monitor injection site
Betamethasone (Celestone)

Description:
- corticosteroid
- increases production of surfactant
- used in preterm labor; can be inhibited for 48 hours
Betamethasone (Celestone)

ADR:

decreases mother's resistant to infection
Betamethasone (Celestone)

Interventions:
- monitor v/s
- monitor signs of infection
Lung surfactant

Description:
- replenishes surfactant and restore surface activity to the lungs
- administered by the intratracheal route
- prevent or treat RDS in preterm infants
Lung surfactant

Drug names:
- Beractant (Survanta)
- Colfosceril palmitate (Exosurf)
Lung surfactant

ADR:
- transient bradycardia
- oxygen desaturation
Lung surfactant

Interventions:
- avoid suctioning at least 2 hours after administration
- monitor for bradycardia and oxygen saturation
- check lung sounds for moist breath sounds
Erythromycin (0.5% Ilotycin) and tetracycline (1%)

Description:
- bacteriostatic and bactericidal
- prophylaxis vs gonorrhea and chlamydia

Author

s1akr

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Card Set

NCLEX-PN Pharmacology Maternity & Newborn

Description

meds needs to know for nclex-pn related to ob and neos

Updated

2010-04-11T21:11:01Z

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