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[h]

Maternity meds

[q] oxytocin

[a] Uterine stimulants increase the strength, frequency, and length of uterine contractions

[q] oxytocin uses

[a] Induction of labor (postterm pregnancy, premature rupture of membranes, pre-eclampsia), Delivery of placenta (postpartum, miscarriage), Management of postpartum hemorrhage, contraction stress test

[q] Dinoprostone

[a] prostaglandin used to promote cervical ripening and to stimulate uterine contractions

[q] methylergonovine

[a] Used for emergency intervention for serious postpartum hemorrhage.

[q] oxytocin adverse effect

[a] Uterine rupture

[q] methylergonovine note

[a] Use only after, and not during labor. Monitor for manifestations of hypertensive crisis (headache, nausea, vomiting,increased blood pressure). Should not be given to clients who have hypertension, organ failure (cardiovascular, kidney, liver). Mothers should not breast feed until 12 hr after their last dose of methergine

[q] Contraindications of oxytocin

[a] Maternal factors (sepsis, an unripe cervix, genital herpes, history of multiple births,uterine surgery). Fetal factors (immature lungs, cephalopelvic disproportion, fetal malpresentation prolapsed umbilical cord, fetal distress, and threatened spontaneous abortion)

[q] oxytocin administration

[a] Use an infusion pump, monitor blood pressure and pulse rate, uterine contractions (frequency and duration), fetal distress

[q] oxytocin goal of treatment

[a] The goal is contractions that last 1 min or less every 2 to 3 min. Monitor for uterine hyperstimulation (contractions lasting longer than 60 seconds, occurring more frequently than every 2 to 3 min, resting uterine pressure greater than 15 mm Hg). Stop infusion and notify the provider immediately.

[q] terbutaline sulfate, nifedipine, indomethacin

[a] Tocolytics- uterine smooth muscle relaxation

[q] Tocolytics adverse effects

[a] Tachycardia, palpitations, chest pain, Tremors, anxiety, headache

[q] Tocolytics Contraindication

[a] Greater than 34 weeks gestation,Acute fetal distress, Severe gestational hypertension or eclampsia, Vaginal bleeding, Cervical dilation greater than 6 cm

[q] Turbutalin administration

[a] Terbutaline is administered subcutaneously. Oral pill dose will not reach desired site of action

[q] Tocolytic notes

[a] Monitor FHR, uterine contractions, pulse, blood pressure, respiratory rate, lung sounds, and daily weights. Withhold/discontinue the medication and contact the provider for reports of chest pain, maternal heart rate greater than 120/min, or presence of cardiac arrhythmias. Limit fluid intake to 1,500 to 2,400 mL/24 hr.Notify the provider if contractions persist or increase in frequency or duration.

[q] Butorphanol, nalbuphine

[a] Pain meds. Give at the peak of contraction

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