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Postpartum and Newborn Drugs

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Title: Postpartum and Newborn Drugs Author: Dena Last modified by: Dena Created Date: 10/31/2009 2:12:29 PM Document presentation format: On-screen Show (4:3) – PowerPoint PPT presentation

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Title: Postpartum and Newborn Drugs


1
Postpartum and Newborn Drugs
  • Dena Evans, EdD(c), MPH, BSN, RN, CNE
  • Assistant Professor
  • Department of Nursing
  • The University of North Carolina at Pembroke

2
Postpartum
  • See Routine Orders pg. 857

3
Five Purposes
  • Prevent uterine atony
  • Relive pain
  • Enhance or suppress lactation
  • Promote bowel function
  • Enhance immunity

4
Pain Relief
  • NSAIDS
  • May prolong bleeding time
  • Take with food or water ? GI upset
  • Narcotics

5
Remember
  • Systemic analgesics
  • Decreased alertness
  • Opioids
  • Bowel function
  • Respirations

6
Perineal Wounds and Hemorrhoids
7
REEDA
  • Redness
  • Ecchymosis
  • Edema
  • Discharge
  • Approximation

8
Medications
  • Witch hazel
  • Nupercainal onitment
  • Nonpharmacological
  • Sitz baths

9
Lactation Suppression
  • Medications not used/less popular due to side
    effects
  • Chlorotrianisene (Tace)
  • Deladumone OB
  • Bromocriptine mesylate (Parlodel)
  • You may be asked about these by a family member
  • Now-support bras, breast bindings, axillary ice
    packs

10
Bowel Function
  • Flatus
  • Antiflatulants
  • Ambulation
  • Increase water intake
  • High-fiber foods

11
Bowel Function
  • Colace
  • Peri-Colace
  • Dulcolax
  • MOM
  • Mineral Oil
  • Nursing Process Laxatives-pg. 864

12
Immunizations
  • Rho D Immune Globulin
  • Explain erythroblastosis fetalis
  • Direct vs. Indirect Coombs test

13
RhoD
  • Given prenatally in approx. 1-2 of Rh- women.
  • Assessed at initial prenatal visit and again at
    28-29 weeks.
  • Can be given IM within 72 hours after delivery
  • Routinely given after maternal/fetal blood
    mixing.
  • Human D immunoglobulin
  • Religious Beliefs

14
Rubella Vaccine
  • AKA German Measles
  • High rate of abortion, neurological defects
  • Congenital rubella syndrome
  • First Trimester-risk
  • After First Trimester-less risk
  • Vaccine is contraindicated during pregnancy

15
Side Effects
  • Burning at injection site acidic pH of vaccine.
  • Urticaria-allergic reaction
  • Malaise
  • Fever
  • Headache
  • Arthralgia
  • Moderate fever

16
Adverse Reactions
  • Hypotension
  • Chills
  • Dizziness
  • Headache
  • Pruritis
  • Injection site reaction
  • Have epinephrine available to treat anaphylaxis

17
Newborn Immediately After Delivery
18
After Delivery-Newborn
  • Erythromycin Ophthalmic Ointment
  • Vitamin K
  • Anti-infective agents (cord stump)
  • Literature supports drug cord care

19
Side Effects/Adverse Reactions
  • EES-chemical conjunctivitis
  • Vitamin K-prevents bleeding
  • Pain and edema at injection site
  • Allergic reaction
  • Hyperbilirubinemia and jaundice
  • Bilirubin and Vitamin K protein binding sites

20
Discharge Immunizations
  • HBV
  • Require maternal consent (signed)
  • Number based on mothers HBsAg status
  • IM-vastus lateralis (preferred site) or rectus
    femoris
  • Negative-only one injection
  • Positive-two
  • HBV vaccine AND HBIG (hepatitis B immune globulin)

21
Nursing Process HBV
  • Page 872
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