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Opioid Analgesics in Pregnancy

Opioid Analgesics in Pregnancy

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OB Medications (Cheatsheet)

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Outline

Overview

Opioids are given for moderate to severe pain
1. They will not provide the same relief as an epidural
They are typically given IV in labor and fast-acting
Given PO in the postpartum period to treat pain

Nursing Points

General

Ideal to be given when needed for breakthrough/acute pain during labor, not chronically throughout pregnancy
1. Newborn can be born addicted→ refer to addicted newborn lesson
History taking is essential before administration to make sure they haven’t been taking them during pregnancy
Some meds are contraindicated if someone is already dependent on specific meds, as they may elicit withdrawal symptoms for both baby and mom

Assessment

Patient history
Pain level
How close is the patient to delivery

Therapeutic Management

Medicate properly
1. Hydromorphone (Dilaudid)
2. Morphine
3. Butorphanol tartrate (Stadol)
4. Nalbuphine (Nubain)
5. Oxycodone
6. Hydrocodone
Naloxone available
Anti nausea medications
1. Nausea is a side effect of Opioids
Monitor for overdose
1. Respirations less than 12/min is a concern
2. Hypotension

Nursing Concepts

Pharmacology
Comfort
Safety

Patient Education

Fast acting
Treatment options

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OB

Concepts Covered:

Pregnancy Risks
Labor Complications
Newborn Complications
Fetal Development
Terminology
Prenatal Concepts
Newborn Care
Postpartum Care
Postpartum Complications
Medication Administration
Labor and Delivery
Studying
Communication

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed

Abruptio Placentae (Placental abruption)

Acyclovir (Zovirax) Nursing Considerations

Addicted Newborn

Alpha-fetoprotein (AFP) Lab Values

Anemia in Pregnancy

Antepartum Testing

Antepartum Testing Case Study (45 min)

Betamethasone and Dexamethasone

Betamethasone and Dexamethasone in Pregnancy

Butorphanol (Stadol) Nursing Considerations

Cardiac (Heart) Disease in Pregnancy

Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)

Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)

Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)

Chorioamnionitis

Day in the Life of a Labor Nurse

Day in the Life of a Postpartum Nurse

Discomforts of Pregnancy

Disseminated Intravascular Coagulation (DIC)

Ectopic Pregnancy

Ectopic Pregnancy Case Study (30 min)

Emergent Delivery (OB) (30 min)

Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)

Erythroblastosis Fetalis

Eye Prophylaxis for Newborn

Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)

Family Planning & Contraception

Fertilization and Implantation

Fetal Alcohol Syndrome (FAS)

Fetal Circulation

Fetal Development

Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)

Fetal Heart Monitoring (FHM)

Fetal Environment

Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)

Fundal Height Assessment for Nurses

Gestation & Nägele’s Rule: Estimating Due Dates

Gestational Diabetes (GDM)

Gestational HTN (Hypertension)

Glucose Tolerance Test (GTT) Lab Values

Gravidity and Parity (G&Ps, GTPAL)

HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)

Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care

Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)

Hepatitis B Vaccine for Newborns

Homocysteine (HCY) Lab Values

Hydatidiform Mole (Molar pregnancy)

Hyperemesis Gravidarum

Hypovolemic Shock Case Study (OB sim) (60 min)

Incompetent Cervix

Infections in Pregnancy

Initial Care of the Newborn (APGAR)

Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)

Labor Progression Case Study (45 min)

Leopold Maneuvers

Lung Surfactant for Newborns

Magnesium Sulfate (MgSO4) Nursing Considerations

Magnesium Sulfate in Pregnancy

Maternal Risk Factors

Mechanisms of Labor

Meconium Aspiration

Meds for Postpartum Hemorrhage (PPH)

Menstrual Cycle

Newborn of HIV+ Mother

Newborn Physical Exam

Newborn Reflexes

Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage

Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Dystocia

Nursing Care Plan (NCP) for Ectopic Pregnancy

Nursing Care Plan (NCP) for Gestational Diabetes (GDM)

Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia

Nursing Care Plan (NCP) for Hyperemesis Gravidarum

Nursing Care Plan (NCP) for Incompetent Cervix

Nursing Care Plan (NCP) for Mastitis

Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Placenta Previa

Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)

Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)

Nursing Care Plan (NCP) for Preterm Labor / Premature Labor

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

Nursing Case Study for Maternal Newborn

Nutrition in Pregnancy

OB (Labor) Nurse Report to OB (Postpartum) Nurses

OB Non-Stress Test Results Nursing Mnemonic (NNN)

Obstetric Trauma for Certified Emergency Nursing (CEN)

Obstetrical Procedures

Opioid Analgesics in Pregnancy

Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)

Oxytocin (Pitocin) Nursing Considerations

Pediatric Vital Signs (VS)

Phytonadione (Vitamin K) for Newborn

Placenta Previa for Certified Emergency Nursing (CEN)

Possible Infections During Pregnancy Nursing Mnemonic (TORCH)

Post-Partum Assessment Nursing Mnemonic (BUBBLE)

Postpartum Discomforts

Postpartum Hematoma

Postpartum Interventions

Postpartum Physiological Maternal Changes

Preeclampsia (45 min)

Postpartum Thrombophlebitis

Precipitous Labor

Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate

Pregnancy Outcomes Nursing Mnemonic (GTPAL)

Preterm Labor for Certified Emergency Nursing (CEN)

Process of Labor – Mom Nursing Mnemonic (4 P’s)

Process of Labor – Baby Nursing Mnemonic (ALPPPS)

Prolapsed Umbilical Cord

Prostaglandins in Pregnancy

Rh Immune Globulin in Pregnancy

Signs of Pregnancy (Presumptive, Probable, Positive)

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

Tips & Advice for Newborns (Neonatal IV Insertion)

Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)