Shared Flashcard Set

Details

Ch.40
Drugs Used in Obstetrics
86
Pharmacology
Not Applicable
04/15/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
At the prenantal visit obtain basic historical information about the woman and family concerning----------? (3)
Definition
diseases, surgeries, and deaths
Term
Ask if the pt. has been treated for--------?(9)
Definition
kidney or bladder problems;high BP;heart disease;rheumatic fever; hypo or hyper thyroidism;DM; allergies to any foods, drugs, or environmental substances; or STDs
Term
Ask if the pt. has been exposed to any ___ since b4 becoming pregnant.
Definition
communicable diseases
Term
Also remember to ask if the pt has ever received_____or_____; and if the pt _____.
Definition
Blood or blood products: smokes
Term
Request the approximate date of the last _____ and results.
Definition
papanicolaou (pap)
Term
Gather data about menstrual pattern such as_____(5) and if any ____ are used.
Definition

age of onset,duration and frequency, date of last full cycle,any bleeding since;

contraceptives

Term
Take an obstetric history including____(6)
Definition
previous live births,stillbirths,miscarriages orinduced abortions,c-sections, or if Rho(d) immune globulin (RhoGam)was needed for incompatibility.
Term
If any previous deliveries were premature obtain info about___(4)
Definition
age of gestation, survival of child, suspected cause, or infection.
Term
Obtain a nutritional history including___(8)
Definition
pts usual wt;how much wt gained or lost in th epast 3 months;favorite foods;foods she avoids;how often does she eat;what has she eaten in the last 3 days;does she take a vitamin, mineral or herb products;cultural food practices to be observed during preganacy.
Term
Psychosocial culture history including ___ (6)
Definition
how does she feel about the pregnancy; cultural practices to follow during pregnancy; what makes up her support group; employment status;level of education, economic status.
Term
Take a med. history including___(5)
Definition
any prescribed, OTC, herbals;alcohol and street drugs,
Term
If she is not currently taking any meds. ask whether any have been taken over the past___
Definition
6 months
Term
Include _(7)__ in the physical exam
Definition
ht and wt; BP (hx of hypertension?); heart rate (take for one full min);respirations;temp;urine specimen;cbc
Term
Assessment done at routine visits during pregnancy includes: (6)
Definition
wt; bp;p; resp;abd measurement including fundal height and fetal heart sounds;any problems or concerns
Term
The pregnant woman who does not experience complications is usually examined ___for the first 6 months;every___in the 7th and 8th month; and ____in the 9th month.
Definition
monthly;every 2 weeks; weekly
Term
S&S of potential obstetric complications are: (10)
Definition
infection;hyperemesis gravidarum;miscarriage;abortion;preterm labor;premature membrane rupture;GDM;hypertension;intrauterine fetal death; and HELLP syndrome (hemolysis elevated liver enzymes and low platelet count)
Term
Assess the status of the fetus by___(5)
Definition
fetal movement counts, contraction stress testing, biophysical profile, ultrasound, or amniocentesis.
Term
When giving magnesium sulfate for pregnancy-induced hypertension (PIH) be sure to assess____(6)
Definition
deep tendon reflexes; respiratory status;sedation level;I&O; seizure precauctions and cardiac status
Term
___ is the antidote for mag sulfate.
Definition
calcium gluconate
Term
After delivery the VS should be checked ____
Definition
every 15 mins for the first hour or until stable then every 30 mins for the nest 2  hrs
Term
After delivery inspect the ___ and note any abnormal swelling or bruising
Definition
perineum
Term
Assess the fundal ___ &___ every 15 mins for 1 hr and then every 30 mins for the next 4 hrs.
Definition
height and firmness
Term
Describe the amount of ___ and the color and presence of clots every ___ mins for 1 hr; every___ for the next 4 hrs; and ___ for the next 12 hrs.
Definition
lochia; 15; 30 mins;hour
Term
Assess breasts for ___&___ approx.3-4 hrs postpardum
Definition
colestrum/breastmilk; engorgement/discomfort
Term
Assessment of the neonate includes___(4)
Definition
patent airway;umbilical cord is observed till pulsation ceases then clamped;apgar at 1 and 5 mins;rapid gestational age assessment
Term
There are four primary clinical indications for the use of uterine stimulants
Definition
induction or augmentation of labor; control of postpardum atony and hemorrhage;control of post surgical hemorrhage (c-section);induction of therapeutic abortion.
Term
____ using a uterine stimulant like___ may be used in cases where cont. of the pregnancy is considered to be greater risk to the mother or fetus than the risk assoc. with induced labor.
Definition
Induction of labor;oxytocin
Term
A Hx of___(5)__ may indicate the need to induce labor.
Definition
precipitous labor and delivary; postterm pregnancy;prolonged preg. with placental insufficency;prolonged rupture of membranes;pregnancy induced hypertension
Term
Vaginal inserts,gels and PO forms of _____are being tested as adj. therapy to help ripen the cervix
Definition
prostaglandins
Term
In general ____ should not be used to hasten labor.The type and force of contraction induced may be harmful to the mother or fetus.
Definition
oxytocin
Term
In occasional cases of ___ there is a prolonged latent phase of cervical dilation or arrest of descent through the birth canal.
Definition
dysfunctional labor
Term
___&____ may be useful in cases of dysfunctional labor.
Definition
low dosages of oxytocin and  continuous fetal monitoring
Term
After delivery the uterus sometimes remains___&___
Definition
flaccid or boggy
Term
____or____ may be used in cases of post pardum atony or hemmorrhage
Definition
continued iv low-dose oxytocin or IM inj. of ergonovine or methylergonovine
Term
Occasionally oral doeses of ___or___ are admin. for a few days after delivary to assist in uterine involution.
Definition
ergonovine oor methylergonovine
Term
Various dosage forms of ___ or ____ may be effective in eveacuating uterine contents.
Definition
prostaglandins or hypertonic(20%)sodium chloride
Term
Uterine smooth muscle is not very responsive to ____stimulation until late in the thirs trimester so it isn't indicated in therapeutic abortion.
Definition
oxytocin
Term
Regardless of the stage of pregnancy stimulans such as ____or__ may be prescribed after the uterus is emptied to control bleeding and maintain uterine muscle tone.
Definition
ergonovine or methylergonovine
Term
____ is a natural chemical in the body that causes uterine and GI smooth muscle stimulation.
Definition
Dinoprostone (prostaglandin E2)
Term
Dinoprostone also plays an active role in ___and ___unrelated to uterine muscle stimulation.
Definition
cervical softening and dilation(cervical ripening)
Term
In higher doses dinoprostone increases ____&____ of contractions
Definition
strength and frequency
Term
Dinoprostone is used to start and continue___.
Definition
cervical ripening
Term
In large doses dinoprostone is used to expel uterine contents in cases of___(4)
Definition
intrauterine fetal death;benign hydatidiform mole;spontaneous miscarriage;and 2nd trimester abortion.
Term
Occasionally dinoprostone and ___are used together to shorten the duration of time required to expel uterine contents.
Definition
oxytocin
Term
The primary therapeutic outcomes assoc. with dinoprostone therapy are:(2)
Definition
cervical softening and dilation b4 labor and evacuation of uterine contents
Term
What is the premed assessment for dinoprostone(4)
Definition
baseline VS, every half hour after initiation of therapy;assess state of hydration;assess uterine activity including discharge;chk for antiemetic and anyidiarrheal meds ordered.
Term
Side effects to expect with dinoprostone therapy
Definition
nausea, vomiting, diarrhea,fever
Term
Temp elevations to ____ occur within __to__ and continue for up to 6 hrs. with dinoprostone
Definition
100.6;15-45 mins;
Term
___does not inhibit dinoprostone-induced fever
Definition
aspirin
Term
side effects to report with with dinoprostone therapy are
Definition
orthostatic hypotension
Term
______is a synthetic prostaglandin E used to prevent nonsteroidal antiinflammatory drug induced ulcer disease.
Definition
misoprostol
Term
The ____also induce uterine contractions in the pregnant uterus.
Definition
prostaglandin E analogs
Term
misoprostol is not approved by the ___ as a cervical ripening agent, induction of labor,or Tx of serious postpardum hemorrhage with uterine atony.
Definition
FDA
Term
Misoprostol is used in combo with____ as an abortifacient.
Definition
mifepristone
Term
Misoprostol should not be used to induce labor in women with a Hx of ___
Definition
c-section
Term
therapeutic outcomes of misorostol therapy are:
Definition
cervical softening and dilation;induction of active labor;reduction of postpardum hemorrhage in th presence of uterine atony;evacuation of uterine contents
Term
Premed assessment of Misoprostol (4)
Definition
baseline VS monitored every half hr;state of hydration;uterine activity& discharge;antemetic & antidiarrheal meds
Term
Rare  adverse effects of misoprostol may include__
Definition
uterine hyperstimulation with subsequent fetal hypoxia,uterine rupture,amniotic fluid embolism
Term
____&__produce more sustained contractions than oxytocin and are used in small doses in postpardum pts.to control bleeding and maintain uterine firmness.
Definition
ergonovine & methylergonovine
Term
the primary therapeutic outcome assoc with ergonovine and methylergonovine therapy is
Definition
reduced postpardum blood loss
Term
premed assessment for ergonovine and methylergonovine is
Definition
base VS and amount and characteristics of discharge,fundal height and contractility
Term
side effects to expect with ergonovine and methylergonovine are
Definition
nausea,vomiting,abd cramping,
Term
SE to report with methylgonovine and ergonovine are
Definition
hypertension
Term
Ergonovine inhibits ___
Definition
prolactin
Term
hypertension and headaches may develop in pts.who have received ___followed by a dosage of ergonovine or methylergonovine
Definition
caudal or spinal anesthesia
Term
oxytocin is a hormone produced in the __ and stored in the ___
Definition
hypothalamus;pituitary gland
Term
when oxytocin is released it stimulates the smooth muscles of____
Definition
uterus;mammory glands and blood vessels
Term
oxytocin is the drug of choice for ___and ___
Definition
inducing labor and for augmentation  of uterine contractions
Term
oxytocin is routinely admin. immediately postpardum to control___&__
Definition
atony and hemorrhage
Term
Therapeutic outcomes assoc with oxytocin therapy are
Definition
initiation of labor;support of uterine contractions and control of potpardum bleeding
Term
SE to expect with oxytocin therapy are
Definition
uterine contractions nausea and vomiting
Term
Contractions longer than ___ require the flow rate of the oxytocin to be slowed or discontinued
Definition
90 sec.
Term
SE to report with oxytocin therapy are
Definition
fetal distress,hypertension,hypotension,water intoxicaton, dehydration,postpardum hemorrhage.
Term
___aka ___ are used primarily to delay or prevent preterm L&D in selected pts.
Definition
uterine relaxants aka tocolytic agents
Term
Tocolytic agents act by inhibiting ___
Definition
uterine muscle contractions
Term
Tocolytic agents are most commonly  used to inhibit labor for __ to __
Definition
2-7 days
Term
Mag sulfate is used primarily to inhibit___or control____
Definition
premature labor;seizures assoc with preeclampsia
Term
when mag sulfate is used as an anticonvulsant or to inhibit labor blood levels shoild be maintained at __to__
Definition
4-8 MeQ/L
Term
at levels aprrox 5-8 to  mEq/L pts begin to show signs of __
Definition
hypermagnesemia
Term
Therapeutic outcomes expected with mag sulfate are;
Definition
arrest of preterm labor;elimination of seizure activity
Term
premed assessment for mag sulfate is
Definition
base Vs;mental status;deep tendon reflexes;I&O; have calcium gluconate or calcium gluconate with Iv admin equip available; base serum mag level; fetal heart rate ,uterine activity monitoring
Term
Se to report with mag sulfate
Definition
deep tendon reflexes,I&O,VS,confusion,overdose
Term
Infants born to mothers who receive magnesium sulfate must be monitored for
Definition
hypotension,hyporeflexia and resp. depression
Term
The primary therapeutic outcome assoc. with terbutaline therapy is___
Definition
arrest of preterm labor
Term
Se to report with terbutaline sulfate
Definition
tachycardia,palpitations hypertension,hypotension,tremors,nervousness,anxiety,restlessness,headache, nausea, vomiting dizziness, hyperglycemia,electrolyte imbalance.
Supporting users have an ad free experience!