14: REPRODUCTIVE/OB

Published on 16/06/2015 by admin

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Last modified 16/06/2015

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Reproductive/OB

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Oxytocin (Pitocin)

CLASSIFICATION

Uterine smooth muscle stimulant

ACTIONS

Contracts uterine and mammary smooth muscle. Increases force, frequency, and duration of uterine contractions.

USES

• Managing incomplete or inevitable abortion

• Controlling postpartum hemorrhage

• Inducing term labor

CONTRAINDICATIONS

• Cephalopelvic disproportion, previous uterine surgery

• Unengaged fetal head, unfavorable fetal position or presentation

• Fetal distress without evidence of imminent delivery

• Placenta previa or cord prolapse or both

• Women with active genital herpes

PRECAUTIONS

• Used with great caution in women who are high parity (5 or more)

SIDE EFFECTS

• Tachycardia, premature ventricular contraction, hypotension

• Nausea, vomiting, water intoxication

NURSING IMPLICATIONS

1. *Frequently assess baseline vital signs, blood pressure, and fetal heart rate.*

2. *Constantly monitor frequency, duration, and strength of contractions.*

3. *Stop the infusion; notify the physician if the resting uterine pressure is above 15 to 20 mm Hg, if contractions are lasting longer than 1 minute, if they are occurring more frequently than every 2 to 3 minutes, or if an alteration in fetal heart rhythm or rate occurs.*

4. Maintain input and output; evaluate for excessive water retention.

5. Do not confuse with vasopressin (Pitressin), which is an antidiuretic hormone.

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Rho(D) Immune Globulin (RhIG) (RhoGAM)

CLASSIFICATION

Immunosuppressant

ACTION

Rho(D) immune globulin (RhIG) is an immunoglobulin that is a concentrated preparation that contains antibodies to Rho(D). This prevents an Rh-negative woman from developing antibodies after exposure to Rho(D)-positive blood.

USES

• Prevents sensitization in Rh-negative pregnant patient given in the last trimester of pregnancy, as well as after abortion or miscarriage.

CONTRAINDICATIONS

• Not given to Rh-positive women.

• Newborn

SIDE EFFECTS

• Uncommon and mild effects

• Slight temperature elevation

NURSING IMPLICATIONS

1. *Administered intramuscularly at 28 weeks’ gestation and again within 72 hours after delive*ry.

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