Labor Pain Control
These medications enter the maternal bloodstream and may cross the placenta during labor.
Systemic analgesics
This should be assessed before giving systemic opioid analgesia during labor.
Maternal respiratory rate, sedation level, blood pressure, and fetal heart rate
This medication is commonly used for labor induction, labor augmentation, and postpartum hemorrhage prevention.
Oxytocin
This postpartum assessment finding suggests uterine atony and increased risk for hemorrhage.
Boggy uterus
This medication is commonly used postpartum for pain and inflammation and should be taken with food.
Ibuprofen
These are two examples of systemic opioid medications that may be used for labor pain.
Fentanyl and Morphine
This safety precaution is important after systemic analgesia or regional anesthesia because the patient may be dizzy, sedated, or have decreased leg sensation.
Fall precautions
This is the action of oxytocin on the uterus.
Stimulating uterine smooth muscle contraction
This medication causes sustained uterine contraction but can raise blood pressure.
Methylergonovine
This medication is given to Rh-negative patients when indicated to prevent Rh sensitization.
Rho(D) immune globulin
This is the major newborn concern when systemic opioids are given too close to birth.
Newborn respiratory depression
These should be monitored frequently after epidural placement.
Maternal blood pressure and fetal heart rate
This contraction pattern means contractions are occurring too frequently and may reduce fetal oxygenation.
Uterine tachysystole
This vital sign must be checked before administering methylergonovine.
Blood pressure
This medication may be continued postpartum for patients with preeclampsia to prevent seizures.
Magnesium sulfate
This type of pain control includes epidural, spinal, and combined spinal-epidural anesthesia.
Regional anesthesia
These symptoms may indicate a high spinal block after regional anesthesia.
Difficulty breathing, numbness rising toward the chest, or trouble speaking clearly
These medications soften and dilate the cervix and may also stimulate uterine contractions.
Prostaglandins
This uterotonic medication may cause bronchospasm and should be used cautiously or avoided in patients with asthma.
Carboprost
These three assessments are essential when a patient is receiving magnesium sulfate.
Respiratory rate, deep tendon reflexes, and uterine output
This maternal side effect of regional anesthesia can decrease uteroplacental perfusion and affect fetal oxygenation.
Hypotension
This nursing action is important when oxytocin causes uterine tachysystole or a nonreassuring fetal heart rate pattern.
Stop or reduce oxytocin infusion according to protocol and notify the provider
These are two examples of prostaglandin medications used for cervical ripening or induction.
Dinoprostone and misoprostol
This is the main purpose of postpartum uterotonic medications.
To keep the uterus firm and reduce bleeding
This Clinical Judgment step involves deciding whether bleeding is decreasing, the uterus is firm, pain improved, and blood pressure is stable after medications.
Evaluating outcomes