36 terms

Pharmacology: Reproductive System (ATI NCLEX Review)

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IUD use is contraindicated for women with what conditions?
Diabetes, history of PID
What medications reduce the effectiveness of oral contraceptives?
Antibiotics, phenytoin, rifampin
What should a client taking oral contraceptives avoid?
Smoking
What is the time frame for use of emergency contraception?
No later than 72 hours after unprotected sex
How long is a hormonal IUD effective for? Copper IUD?
Hormonal: 5 years, Copper: 10 years
When should a cervical diaphragm be refitted?
After childbirth or weight gain/loss of over 10 lbs
What is the time frame for cervical diaphragm use?
Insert 6 hr prior to intercourse, leave in for 6 hrs after intercourse
What class of drugs do dinoprostone and misoprostol belong to?
oxytocic cervical ripening agents. they soften & thin the cervix
What is a major adverse effect of cervical ripening agents?
tachysystole
What should the client do after administration of a cervical ripening agent?
Bedrest for at least 2 hours (30 min for the gel) after insertion
What is the purpose of oxytocin in antepartum, intrapartum, and postpartum?
Antepartum: for contraction stress test
Intrapartum: induction or augmentation of labor
Postpartum: promote uterine tone
What are contraindications for oxytocin use?
placental abnormalities, fetal malpresentation, previous uterine surgery, fetal distress, Bishop Score <6
What nursing intervention should be implemented for a patient on oxytocin exhibiting signs of hyperstimulation?
Administer 10L oxygen via face mask
What must be monitored for a patient on oxytocin?
Uterine contractions, fetal heart rate.
Used in postpartum: monitor for uterine bleeding
When is methylergonovine (Methergine) used?
Fpr postpartum hemorrhage
Methylergonovine should be used with caution in patients with what conditions?
hypertension, preeclampsia, heart disease, venoatrial shunts, mitral valve stenosis, sepsis, CV/hepatic/renal impairment
What 3 things should the nurse be assessing in a patient taking methylergonovine?
BP, uterine bleeding, uterine tone
When should terbutaline sulfate not be administered?
HR >130 bpm or patient has chest pain
What is the antidote to terbutaline sulfate?
a beta-blocking agent
Which tocolytic medication can cause hyperglycemia, chest pain, and tremulousness?
terbutaline sulfate
What medication should not be used concurrent with nifedipine?
Magnesium sulfate
What must the nurse monitor in a patient taking magnesium sulfate?
vital signs, deep tendon reflexes (DTRs), magnesium levels (therapeutic range: 4-8 mg/dL), urinary output
What should be administered for magnesium sulfate toxicity?
Calcium Gluconate 10%
What are some key adverse effects of magnesium sulfate use?
respiratory depression, diminished DTRs, decreased urine output
What is the effect of tocolytic medications?
act on uterine muscle to cease contractions
What condition that sometimes develops in pregnancy does magnesium sulfate help treat?
Preeclampsia. Mag sulfate is given to decrease risk of seizures
What does betamethasone do?
Promotes fetal lung maturity in preterm labor (for fetus b/w 24-34 wks gestation)
How does betamethasone adversely affect the mother when taken?
Fluid retention, elevate BP, maternal hyperglycemia, transient increase in WBC
How should betamethasone be administered?
2 doses (usually IM) 24 hrs apart. Repeat doses not recommended
What precautions must be taken before giving a patient Rho(D) Immune Globulin?
confirm mother is Rh-, never administer to a neonate, never administer IV
What are indications for RhoGAM use? When is it administered?
-Within 72 hr after birth if mother is Rh negative, newborn is Rh positive, and Coombs' test is negative
-Prophylactically at 28 wks gestation and after any event where fetal cells can mix with maternal blood (e.g. miscarriage, amniocentesis, induced abortion)
When should a not-immune woman be administered varicella vaccine in pregnancy?
Postpartum period
How long after varicella administration should pregnancy be avoided?
3 months
Why is indomethacin given in L&D?
Tocolytic for preterm labor. Only given for gestational age <32 wks
Why is methotrexate given in L&D?
May be used with ectopic pregnancy to stop the growth of the embryo to save the tube
Why is tamoxifen used? What does it increase the risk of?
Tx breast cancer. Icnreases risk of endometrial cancer, deep vein thrombosis, pulmonary embolism