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OB Postpartum
Postpartum meds
19
Nursing
Not Applicable
01/22/2012

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Cards

Term
Docusate Sodium
Gastrointestinal agent, stool softener.
Definition
Use: For people who should avoid straining during defecation and for treatment of constipation associated with hard, dry stools.
Dose: Po 50-500 mg/d. PR 50- 100 mg added to enema fluid
Adverse Reactions: Diarrhea, throat irritation, rash, nausea, and bitter taste.
Contraindications, Precautions: Atonic constipation, nausea, vomiting, abdominal pain, fecal impaction, structural anomalies of colon and rectum, intestinal obstruction or perforation. Take with caution if have history of CHF, edema, diabetes mellitus.
Nursing Considerations: Increase fluids - take with a glass of water. Teach to eat fruit, vegetables, and fiber to help promote optimal bowel function.
Term
Methergine (mrthylergonovine maleate)
Autonomic nervous system agent/ adrenergic agonist
Definition
Use:Ergot-derivative, not to be administered prior to delivery of the placenta
Dose: Uterine subinvolution: 0.2 mg IM/Very cautious with IV! (may be repeated at 2-4 hr intervals up to 5 doses) then 0.2 mg ORALLY 3- 4 times a day
Adverse Reactions: Nausea/vomiting, hypertensive episodes, bradycardia, allergic reactions, ergotism tinnitus dizziness, sweating – rare MI and severe hypertension.
Contraindications, Precautions: Do not take for more than 1 week. If give IV, monitor BP and HR and give over 1 minute. IV not preferred method.
Nursing Considerations: Should not be routinely administered I.V. because of possibility of inducing sudden hypertension and cerebrovascular accident
Term
Prostin (Hemabate)
Oxytocic, abortifacient, antihemorrhagic
Definition
Use: Termination of pregnancy and refractory postpartum uterine bleeding
Dose: IM Adults: Refractory postpartum uterine bleeding: Initial: 250 mcg;
Adverse Reactions: Headache, nausea/vomiting, diarrhea, uterine rupture, dyspnea, hiccups, fever, flushing
Contraindications, Precautions: Use with caution in patients with history of asthma, hypotension or hypertension, cardiovascular, adrenal, renal or hepatic disease, anemia, jaundice, diabetes, epilepsy or compromised uteri
Nursing Considerations: Observe carefully for reports of wheezing and chest pain, changes in BP and pulse, monitor for contractions, excessive cramping, nausea, vomiting, diarrhea, fever may result. Monitor vaginal bleeding.
Term
Tucks
Definition
Use: Pads soaked in Witch Hazel. Relieves pain of lacerations/hemorrhoids.
Dose: Sparingly. External use only
Adverse Reactions: Rash, irritation, burning. Cold sensation when used initially.
Contraindications, Precautions: Avoid if allergic to any of its components.
Nursing Considerations: Teach to apply to episiotomy, lacerations, & hemorrhoids to relieve pain and discomfort prn. Warn pt. it feels cold when applied initially.
Term
Dermoplast/Americaine Spray
Topical Anesthetic
Definition
Use: Numbs/relieves pain of lacerations and cuts
Dose: Sparingly. External use only.
Adverse Reactions: Rash, irritation, burning. Cold sensation when sprayed initially.
Contraindications, Precautions: Avoid if allergic to any of its components. Keep away from face.
Nursing Considerations: Teach to apply to episiotomy, lacerations, & hemorrhoids to relieve pain and discomfort prn. Warn pt. it feels cold when sprayed.
Term
Rubella
Definition
Use: Stimulate active immunity against rubella virus
Dose: Single-dose, inject subcutaneously in outer aspect of the arm.
Adverse Reactions: Burning or stinging, redness at the injection site, joint aches or pain; about 2-4 weeks later may have a rash, malaise, sore throat, or headache,
Contraindications, Precautions: Pregnancy
Nursing Considerations: Determine weather a woman has sensitivity to neomycin, gelatin, other immunizations, is immunosupressed, or has received blood profucts. Teach expected effect-sore arm, muscle aches/pains, slight fever, possible effects, and comfort measures to use if effects occur. Instruct women to avoid pregnancy for about one month after vaccination due to potential teratogenic effects to fetus.
Term
Ibuprofen (Motrin) Analgesic, antipyretic, and NSAID.
Definition
Use: Blocks prostaglandin synthesis. Nonsteroidal anti- inflammatory, analgesic, and antipyretic effect. Inhibits platelet aggregation and prolongs bleeding.
Dose, Dose: Mild to moderate pain 400mg q4-6h. Fever 200-400mg tid or qid.
Adverse Reactions: Headache, dizziness, anxiety, drowsiness, depression, blurred vision, impaired healing, heartburn, nausea, occult blood loss, aplastic anemia, acute renal failure, rectal itching, toxic hepatitis, and anaphylaxis. Contraindications, Precautions: Patient in whom urticaria, severe rhinitis, bronchospasm, angioedema. Caution use in people with hypertension, history of GI ulceration, and impaired hepatic renal function
Nursing Considerations: Take with food or milk to decrease potential GI side effects. Monitor effectiveness, monitor patient for history of cardiac decompensation closely for evidence of fluid retention and edema, monitor for GI distress and signs and symptoms of bleeding.
Term
Ferrous Sulfate
Iron preparation.
Definition
Use: To correct simple iron deficiency and to treat iron deficiency anemias.
Dose: PO Iron deficiency: 750- 1500mg/d in 1- 3 divided doses. Iron supplement: pregnancy , 300-600mg/d in divided doses.
Adverse Reactions: Nausea, heartburn, constipation, black stools, yellow brown- discoloration of eyes, rickets, massage overdosage, which cause shock, cardiovascular collapse, liver necrosis, and death.
Contraindications, Precautions: Peptic ulcer, regional enteritis, ulcerative colitis; and hemolytic anemia. Caution use in pregnancy and lactation.
Nursing Considerations: Monitor Hgb and reticulocyte values during therapy. Continue iron therapy for 2-3 months after the hemoglobin level has returned to normal. Consuming citrus fruit or tomato juice with iron preparation may increase it’s it absorption Milk, calcium, eggs, or caffeine beverages when taken with the iron preparation may inhibit absorption.
Term
Prenatal Vitamin/ PNV
Definition
Use: To make sure woman gets all the supplements she needs when pregnant. Has increased level of folic acid as required to decrease the incidence of neural tube defects.
Dose: 1 tablet PO every day. Recommended to take 400 mcg folic acid, 3 months before conception to ↓ incidence of neural tube defects (NTD).
Adverse Reactions: Abdominal pain, constipation, dark stools, diarrhea, nausea, vomiting, Allergic reaction
Contraindications, Precautions: Due to calcium content, use caution with kidney stones. Iron supplementation should not be used with hemochromatosis and hemosiderosis. Use caution with severe renal or hepatic dysfunction or failure.
Nursing Considerations: Pre natal vitamins should be taken daily, to insure the women obtains the necessary vitamins during pregnancy. Woman can obtain the vitamins as well in a balanced diet. Teach pt. to avoid taking other OTC vitamins because can cause toxicity or encourage her to check with her HCP before doing so.
Term
Masse cream
Definition
Use: Ointment to keep nipples supple/soft and prevent cracking.
Dose: Apply sparingly to nipples.
Adverse Reactions: Rash if allergic to anything in the ointment.
Contraindications, Precautions: Do not use if allergic to wool.
Nursing Considerations: Allow nipples to air dry after expressing a drop of breast milk on the end of the nipples. Apply sparingly if expressed milk not sufficient.
Term
Nupercainal Ointment
topical anesthetic
Definition
Use: Relieving discomfort, itching, and burning caused by hemorrhoids.
Dose: Apply to the affected area three or four times a day as needed. The largest amount that may be used in a 24-hour period is 30 grams (g), but much smaller amounts are usually enough. Children 2 years of age and older—Apply to the affected area three or four times a day as needed. Do not use more than 7.5 g in a 24-hour period.
Side Effects, Adverse Reactions: Severe allergic reactions; new or worsening redness, swelling, irritation, or pain at the application site; rectal bleeding.
Contraindications, Precautions: Avoid applying other skin medications on the same treatment area. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors.
Nursing Considerations: Do not use near the eyes or over denuded surfaces or blistered areas. Wash your hands after applying dibucaine topical. - It is best to use no more than 1 tube of dibucaine per day (24 hours).
Term
Tylenol #3
narcotic pain reliever and non-narcotic pain reliever
Definition
Use: to help relieve mild to moderate pain.
Dose: Doses may be repeated up to every 4 hours.
Adverse Reactions: Nausea, vomiting, constipation, lightheadedness, dizziness, or drowsiness.
Contraindications, Precautions: Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders (such as head injury, tumor, seizures), breathing problems (such as asthma, sleep apnea, chronic obstructive pulmonary disease-COPD), kidney disease, liver disease, mental/mood disorders (such as confusion, depression), personal or family history of regular use/abuse of drugs/alcohol, stomach/intestinal problems, difficulty urinating.
Nursing Considerations: Montitor for S/S of hepatoxicity in individuals with poor nutrition, alcoholics, poisonings, and potental abuse from psychological dependance. Do not exceed recommended dose; do not take for longer than 10 days. Report rash, unusual bleeding or bruising, yellowing of skin or eyes, changes in voiding patterns.
Term
Codeine
narcotic pain reliever
Definition
Use: relieve mild to moderate pain.
Dose: Initial dose: 30 mg orally, IM, subcutaneously, or IV every 6 hours as necessary. May titrate dose to achieve desired analgesic effect. Doses up to 60 mg orally, IM, subcutaneously, or IV every 4 hours have been used.
Adverse Reactions: difficulty breathing or swallowing, fast pounding or irregular heartbeat, rash, itching, hives, changes in vision, seizures.
Contraindications, Precautions: Do not take codeine with any other narcotic pain medications, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing.
Nursing Considerations: Observe patient for excessive sedation, respiratory depression, constipation. Codeine may cause constipation which may be problematic in patients with unstable angina, and patients after myocardial infarction.
Term
Epifoam
combination topical corticosteroid and local anesthetic.
Definition
Use: works by reducing skin inflammation, decreases pain in the affected area.
Dose: Apply to affected area 3 to 4 times daily.
Adverse Reactions: Severe allergic reactions; acne-like rash; excessive hair growth; inflamed hair follicles; inflammation around the mouth; muscle weakness; rectal pain, burning, cracking, itching, bleeding, peeling, or irritation not present before using Epifoam Foam; thinning, softening, or discoloration of the skin; unusual weight gain, especially in the face.
Contraindications, Precautions: allergic to any ingredient in Epifoam Foam.
Nursing Considerations: Establish baseline and continuing data on BP, weight, fluid and electrolyte balance, and blood glucose. Lab tests: Periodic serum electrolytes blood glucose, Hct and Hgb, platelet count, and WBC with differential.
Monitor for adverse effects. Older adults and patients with low serum albumin are especially susceptible to adverse effects. Be alert to signs of hypocalcemia
Term
Lortab
narcotic
Definition
Use: relieve moderate to severe pain.
Dose: The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dosage should not exceed 6 tablets.
Adverse Reactions: Shallow breathing, slow heartbeat; feeling light-headed, fainting; confusion, fear, unusual thoughts or behavior; seizure; problems with urination; or nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice. Anxiety, dizziness, drowsiness; mild nausea, vomiting, upset stomach, constipation; headache, mood changes; blurred vision; ringing in your ears; or dry mouth.
Contraindications, Precautions: This product should not be administered to patients who have previously exhibited hypersensitivity to hydrocodone or acetaminophen. Patients known to be hypersensitive to other opioids may exhibit cross-sensitivity to hydrocodone.
Nursing Considerations: Instruct patient on how and when to ask for pain medication. Advise patient to call for assistance when ambulating. Change positionsslowly to avoid orthostatic hypotension.
Term
Percocet
Narcotic analgesic
Definition
Use: For moderate to moderately sever pain. Can be used in aspirin sensitive women.
Dose: Po oxycodone hydrochloride 5mg, acetaminophen 325mg. 1-2 tablets every 4 hours prn.
Adverse Reactions: Acetaminophen: hepatotoxicity, headache, rash, hypoglycemia Oxycodone: respiratory depression, apnea, circulatory depression, euphoria, facial flushing, constipation, suppression of cough reflex, urethral spasm, and urinary retention.
Contraindications, Precautions: Ineffective breathing pattern related to drug therapy and constipation related to slowed gastrointestinal activity.
Nursing Considerations: Determine whether a woman is sensitive to acetaminophen or codeine; has bronchial asthma, respiratory depression, convulsive disorder. Observe women carefully for respiratory depression if given with barbiturates or sedative/hypnotics. Teaching should include name of drug, expected effect, possible adverse effects. Teach may cause dizziness, drowsiness so avoid driving when taking med. Alcohol potentates effect so warn against taking it with alcohol.
Term
Dilaudid
Definition
Use: relieve moderate to severe pain. It also may be used to decrease coughing.
Dose: Pain: Older Children and Adults:
Oral, I.M., I.V., S.C.: 1-4 mg/dose every 4-6 hours as needed; usual adult dose: 2 mg/dose
Rectal: 3 mg every 6-8 hours
Antitussive: Oral:
Children 6-12 years: 0.5 mg every 3-4 hours as needed
Children >12 years and Adults: 1 mg every 3-4 hours as needed
Adverse Reactions: difficulty breathing, fainting, dizziness, lightheadedness, drowsiness, nausea, vomiting, constipation, stomach pain, rash, difficulty urinating
Contraindications, Precautions: Increased toxicity: CNS depressants, phenothiazines, tricyclic antidepressants may potentiate the adverse effects of hydromorphone.
Nursing Considerations: Observe patient for oversedation, respiratory depression, implement safety measures.
Term
Ambien
sedative-hypnotics
Definition
Use: to treat insomnia.
Dose: adults is 10 mg once daily immediately before bedtime. The total Ambien dose should not exceed 10 mg per day.
Adverse Reactions: Rash, hives, itching, swelling of the eyes, face, lips, tongue, or throat, feeling that the throat is closing, difficulty breathing or swallowing, hoarseness, shortness of breath, nausea, vomiting, pounding heartbeat, chest pain, blurred vision or other vision problems.
Contraindications, Precautions: Contraindicated with hypersensitivity to zolpidem. Use cautiously with acute intermittent porphyria, impaired hepatic or renal function, addiction-prone patients, pregnancy, lactation.
Nursing Considerations: Limit amount of drug dispensed to patients who are depressed or suicidal. Withdraw drug gradually if patient has used drug long-term or if patient has developed tolerance. Take this drug exactly as prescribed. Do not exceed prescribed dosage. Long-term use is not recommended.
Term
Demerol
Narcotic Analgesic
Definition
Use: synthetic morphine-like compound; control of moderate to severe pain and obstetric analgesia.
Dose: Obstetric=IM/SC 50-100 mg; Pain PO/SC/ IM/IV50-150mg.
Adverse Reactions: Respiratory depression, convulsions, constipation, sedation, cardiovascular collapse/arrest.
Contraindications, Precautions: Contraindicated if convulsive disorder, acute abdominal condition, pregnancy prior to labor; use caution if impaired liver or kidney function.
Nursing Considerations: Give in smallest dose possible; note respiratory rate; do not smoke and walk without assistance after receiving the drug; be aware of nausea, vomiting and dizziness associated with fall in BP; caution if breast feed while taking, do not take with alcohol or another CNS depressant. And causes dizziness and drowsiness.
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