Pregnancy & Preterm
What drugs are safe to use during pregnancy to alleviate nausea and constipation?
Nausea : Pyridoxine (aka vit b 6)- category A, Doxycycline - category A
Constipation: docusate sodium
What are priority interventions before an epidural is administered? How can you prevent spinal headaches?
IV bolus
Make sure you have oxygen and resuscitation equipment available at pt bedside
Monitor FHR
EBP is to insert an indwelling catheter before epidural (bc issues/ risk like urinary retention because the women cannot feel)
Increase fluids and lower HOB for spinal headaches
What is vitamin K given to infants for? Where is it given?
Vitamin k deficiency (bleeding)
THIGHS - vastus lateralis
Who cannot receive live vaccines?
Immunocompromised pts
What is the drug terbutaline used for and the drug class?
Drug class: Tocolytic drug
Used to slow down preterm labor and decrease contractions
helps relax resp. tract
What are your priority nursing interventions when administering IV opioid analgesics to a client in labor?
Watch their respirations, and keep naloxone nearby
Do not administer within 4 hours of delivery of an infant
Monitor fetal HR and mother's vitals CONTINUOUSLY !!!
Where is erythromycin ophthalmic ointment administered to a newborn? Why?
Lower conjunctival sac to inner canvas to outer canvas
to prevent blindness in case mother had chlamydia
Where should immunizations be given to infants and how can you provide atraumatic care while administering immunizations?
Parents and a pacifier
Flu: must be 6 months
Given in: vastus lateralis
What medication is given to accelerate fetal lung development after tocolytic therapy is given?
Corticosteroids: betamethasone
What are your top priorities when administering oxytocin to a client?
Continuously monitor FHR
Given IV- need secondary medication
Monitor the intensity, duration, and frequency of contractions
If a contraction is longer than 60 seconds, more frequent than 2-3 minutes: hyper contracting ,Stop infusion!
The nurse is caring for a newborn infant whose mother is HBsAg-negative. The nurse expects to give the infant what vaccine?
Recombinant hepatitis B vaccine
If mom is positive: immunoglobulin, still receives the vaccine
What immunization should be completed prior to infant's first bday
Hep B and rotavirus
What should be assessed in a woman that is receiving magnesium sulfate?
-Respirations, breath sounds, Deep tendon flexes, pain, uterine contractions
-Serum magnesium level: 1.5-2.5
The mother has a _____ _RH factor and the fetus has a ______ RH factor which means the mother needs to receive the _______________?
What are the interventions for this?
-NEGATIVE, POSITIVE
-Rho (D) immune globulin
Administered at 28 weeks and at birth
Does not have to be given if it is their first pregnancy at 28 weeks but has to at birth
How is beractant administered to preterm infants?
intratracheal
(within 15 min of birth)
What are some possible reactions to vaccines? What is considered normal and urgent?
Normal reactions: Simple rash, erythema ,warm at the site, low-grade fever
Cold pack for first 24 hours, rotate cold and warm after 24 hours, and give a little Tylenol
Severe anaphylaxis, high-grade fever → parents should bring back in
What is the PRIORITY nursing intervention if a pregnant pt presents with low BP during labor and delivery?
Give bolus IV fluids
A hypertensive pt is experiencing postpartum hemorrhage. What med will be given to control the hemorrhage? What is usually given to a nonhypertensive pt?
Oxytocin can be given!
Methylergonovine is usually given but it is contraindicated because the patient is hypertensive- because it will increase BP
What immunization is given at birth? What should the nurse do if the mother refuses vaccination?
Hepatitis B, document if mom refuses
What are the 3 types of immunity?
Active immunity: Body-produced antibodies (natural)
Passive immunity: receive antibodies from another source
Community immunity: aka herd immunity, Occurs when most of the community is immunized against contagious diseases, allowing protection of those not immunized.