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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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Hesi Prep maternity

Concepts Covered:

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

Study Plan Lessons

Alpha-fetoprotein (AFP) Lab Values

Antepartum Testing

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

What the Heck is Antepartum Testing? – Live Tutoring Archive

Antepartum Testing Case Study (45 min)

Blood Glucose Monitoring

Body System Assessments

Clindamycin (Cleocin) Nursing Considerations

Congestive Heart Failure (CHF) Labs

Disseminated Intravascular Coagulation (DIC)

Eye Prophylaxis for Newborn (Erythromycin)

Eye Prophylaxis for Newborn

Erythroblastosis Fetalis

Fetal Development

Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)

Fetal Environment

Fetal Heart Monitoring (FHM)

Fetal Heart Monitoring Like A Pro – Live Tutoring Archive

Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive

Gestational Diabetes (GDM)

Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive

Gestational HTN (Hypertension)

Glucagon Lab Values

Glucose Tolerance Test (GTT) Lab Values

Gravidity and Parity (G&Ps, GTPAL)

HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)

Hemoglobin A1c (HbA1C)

Isotonic Solutions (IV solutions)

Labor Progression Case Study (45 min)

Leopold Maneuvers

Magnesium Sulfate

Magnesium Sulfate (MgSO4) Nursing Considerations

Magnesium Sulfate in Pregnancy

Maternal Risk Factors

Mechanisms of Labor

Meds for Postpartum Hemorrhage (PPH)

Meds for PPH (postpartum hemorrhage)

Methylergonovine (Methergine) Nursing Considerations

Newborn Physical Exam

Newborn Reflexes

Nifedipine (Procardia) Nursing Considerations

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

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Diabetes Mellitus (DM)

Nursing Care Plan (NCP) for Dystocia

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

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Placenta Previa

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

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

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

Nursing Care Plan for Newborn Reflexes

Nursing Case Study for Maternal Newborn

Nutrition Assessments

Nutrition in Pregnancy

Nutritional Requirements

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

OB Non-Stress Test Results Nursing Mnemonic (NNN)

OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive

Obstetrical Procedures

Opioid Analgesics in Pregnancy

Pediatric Vital Signs (VS)

Physiological Changes

Possible Infections During Pregnancy Nursing Mnemonic (TORCH)

Postpartum Discomforts

Postpartum Hematoma

Postpartum Hemorrhage (PPH)

Postpartum Interventions

Postpartum Physiological Maternal Changes

Postpartum Thrombophlebitis

Precipitous Labor

Preeclampsia (45 min)

Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)

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

Preload and Afterload

Premature Rupture of the Membranes (PROM)

Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)

Process of Labor – Baby Nursing Mnemonic (ALPPPS)

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

Process of Labor 2 – Live Tutoring Archive

Prolapsed Umbilical Cord

Promethazine (Phenergan) Nursing Considerations

Prostaglandins in Pregnancy

Protein (PROT) Lab Values

Retinopathy of Prematurity (ROP)

Signs of Pregnancy (Presumptive, Probable, Positive)

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

Terbutaline (Brethine) Nursing Considerations

Umbilical Cord Vasculature Nursing Mnemonic (2A1V)

Uterine Stimulants (Oxytocin, Pitocin)

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

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