OB meds

what are the tocolytic meds

Mag sulfate

Indomethacin (contraindicated > 32 wks, risk of premature PDA closure)

Nifedipine ( causes transient hypotension and tachycardia)

Terbutaline (tachycardia), headache, flushing)

what do tocolytic meds do?

inhibit uterine contractions= increase uterine rest= increase uteroplacental reperfusion= increase fetal oxygenation

clients are screened between 24-28 weeks. GDM is diagnosed if + screening for 2 step oral glucose challenge test

nonfasting + sugar drink + less than 140 = negative > 140 ( confirm w same test but fasting)

what are the uterine stimulants?

oxytocin , methylergonovine, carboprost

what should you monitor in oxytocin

uterine tachysystole

methylergonovine is contraindicated in

hypertension

carboprost (prostaglandin f2-alpha) is contraindicated in

asthma - DUE TO BRONCHOCONSTRICTION

when is Rh immune globin administered?

28 wks + within 72 hr postpartum ( if baby RH+)

indications for use of tocolytics

1.) delay preterm labor(< 37 wks)

2.) slow or stop contractions in uterine tachysystole (>5 contractions in 10 min)

what are the antifibrinolytics and wht do they do ?

Tranexamic acid (TXA)

*Prevent clot breakdown to promote homeostasis (given when other interventions fail)

what are the cervical ripening agents?

misoprostol and dinoprostone

what should you monitor in betamethasone

maternal hyperglycemia

in nifedipine teach clients to rise slowly to prevent

orthostatic hypotension

indomethacin has a risk for premature closure of fetal

ductus arteriosus

when is TXA contraindicated ?

blood clot history

bladder distention inhibits uterine contractions→ hemorrhage. ensure clients

voids as soon as possible after delivery

*Have client void with in 8 hr of urinary catheter removal

how to minimize pain in perineal care after delivery

1.) ice packs

2.) or/iv analgesics

3.) anesthetic peineal spray

4.) astringent ( compresses for hemorrhoid relief (witch hazel)

how to maintain perineal hygiene

1.) cleanse the perineum w squirt bottle (peri bottle) filled w warm water

2.) offer sitz baths (shallow, warm water) for comfort and cleanilness