What are Tocolytics?
- Uses? (2)
Medications that produce uterine relaxation
- Stops contractions
- Prevent preterm birth
Adverse Effects of Tocolytics
Depressed respiration, depressed reflexes, hypotension, muscle weakness, flushing
Interventions for Tocolytics
Position the client on her side to enhance placental perfusion
Monitor VS of both Mom and Babe
What is Magnesium Sulfate?
- Uses (2)
It is a CNS depressant and smooth muscle relaxant.
- Stops preterm labour
- Prevents and controls seizures in pre-eclampsia and eclampsia
Adverse Effects of Mag Sulf.
Respiratory depression, depressed reflexes, flushing, hypotension, muscle weakness, decreased urine output
Interventions for Mag Sulf.
MUST monitor kidney function and mag levels to avoid toxicity.
What are Betamethasone and Dexamethasone?
- Use
Corticosteroids that accelerate fetal lung maturity via increasing surfactant production.
- For clients in preterm labour between 28-32 weeks gestation
Adverse Effect for corticosteroids
Decrease resistance to infection, pulmonary edema, elevated blood glucose in clients with diabetes
What are Opioids used for?
Which opioids are used here? (6)
To relieve moderate to severe pain associated with labour
hydromorphone, meperidine, fentanyl, sufentanil, butorphanol tartrate, nalbuphine
Antidote for Magnesium Sulfate?
Calcium Gluconate
Adverse Effects of Opioids
Dizziness, nausea, vomiting, sedation, decreased BP, decreased resps, diaphoresis, urine retention
Interventions for Opioids
Monitor VS (especially resp status), monitor fetal HR,
What are Misoprostol and Dinoprostone?
- Uses (2)
Prostaglandins used to ripen cervix and stimulate contractions.
- Preinduction cervical ripening
- Induction of labour
Adverse Effects of prostaglandins
GI effects (diarrhea, nausea, vomiting), fever, chills, flushing, headache. hypotension, hyperstimulation of the uterus
Interventions for prostaglandins
Have the client void before admin and then have her maintain a supine with lateral tilt or side-lying position for 30-60mins after admin.
Monitor VS, fetal HR
Antidote for opioids
Naloxone
What are Oxytocics?
- Uses (3)
Simulates smooth muscle of the uterus, promotes milk letdown
- Induces labour
- Controls post-partum bleeding
Adverse Effects of Oxytocin
Dysrhythmias, changes in BP, uterine rupture, water intoxication, and uterine hypertonicity
Interventions for Oxytocin
Monitor VS q15mins
Monitor frequency, duration and force of contraction q15mins
Monitor fetal heart q15 mins
What 6 actions do you take if pt develops uterine hypertonicity? (secondary to oxytocin admin)
- Stop oxytocin infusion
- Turn client on her side
- Increase the flow of the IV fluid (not the oxytocin)
- Administer O2 8-10L/min
- Assess VS of Mom and Babe
- Document event, actions taken and response
What is Methylergonovine maleate (Ergot Alkaloid) and Carboprost tromethamine?
- Uses (2)
Directly stimulates uterine muscle, increases the force and frequency of contractions
- Controls postpartum haemorrhage
- Controls postabortal haemorrhage
Adverse Effects of Ergot Alkaloid
Most major complication being?
Nausea, uterine cramping, bradycardia, dysrhythmias, MI, HTN
Can produce arterial vasoconstriction and vasospasm of the coronary arteries
Major contraindications of Ergot Alkaloid
Not to be used during pregnancy, and in clients with significant cardiovascular disease, peripheral vascular disease, or HTN
What is Rh immune globulin used for?
Prevents anti-Rh antibody formation in Rh-negative patients
