S ti m u la t e s u t e r i n e s m o o t h m u s c

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Unformatted text preview: o r P i tu it a r y . S ti m u la t e s u t e r i n e s m o o t h m u s c le , r e s u lti n g in in c r e a s e d s t r e n g th , d u r a tio n a n d fr e q u e n c y o f c o n t r a c tio n s . U te r in e s e n s iti v i ty t o o x y t o c in in c r e a s e s g r a d u a lly d u r in g g e s ta ti o n . O x y to c in h a s v a s o a c tiv e a n d d iu r e tic p r o p e r t ie s . In d i c a t io n s : in d u c tio n o r a u g m e n ta tio n o f la b o r a t o r n e a r t e r m . M a i n te n a n c e o f f ir m u te r in e c o n t r a c ti o n s a f te r b ir t h t o c o n tr o l p o s tp a r t u m b le e d in g . M a n a g e m e n t o f in e v ita b le o r in c o m p le t e a b o r ti o n . C o n t r a in d i c a t io n s /P r e c a u t io n s : p la c e n t a p r e v ia , v a s a p r e v ia , n o n r e a s s u r in g fe t a l h e a r t r a t e p a t te r n s , a b n o r m a l fe ta l p r e s e n ta t o n , p r o la p s e d u m b il ic a l c o r d , p r e s e n tin g p a r t a b o v e p e lv ic in le t, p r e v io u s u t e r in e in c is io n , a c t iv e g e n ita l h e r p e s in f e c t io n , p e l v i c s tr u c t u r a l d e f o r m itie s , in v a s iv e c e r v ic a l c a r c i n o m a . S id e e f f e c t s : - h y p e r to n ic u t e r in e a c tiv ity - im p a ir e d u t e r in e b lo o d flo w - u t e r i n e r u p tu r e - a b r u p tio p la c e n t a U te r in e h y p e r s e n s itiv it y m a y r e s u l t in fe t a l b r a d y c a r d ia , t a c h y c a r d ia , r e d u c e d fe t a l h e a r t r a te v a r i a b i lit y , a n d la te d e c e le r a t io n s . F e t a l a s p h y x i a m a y o c c u r. F e ta l o r m a te r n a l t r a u m a ( o r b o th ) m a y o c c u r fr o m r a p id b ir th . P r o lo n g e d a d m in is t r a t io n m a y c a u s e m a te r n a l f lu id r e te n ti o n , le a d in g t o w a te r in t o x i c a t io n . D r u g in te r a c t io n s in c lu d e v a s o p r e s s o r s a n d th e h e r b e p h e d r a , c a u s in g h y p o t e n s io n . In d u c t io n o r A u g m e n t a t io n o f L a b o r : I V i n f u s io n , s e c o n d a r y lin e . P u m p c o n tr o lle d . M ix tu r e s h a v in g 6 0 m illiu n it s / m l a r e m o r e c o n v e n i e n t b e c a u s e o f p u m p s e tt in g . C o m m o n m ix tu r e s c o n t a i n in g 6 0 m illiu n it s / m l in c l u d e 1 5 u n its ( 1 .5 m l ) in 2 5 0 m l o f s o lu tio n ; 3 0 u n it s ( 3 m l ) in 5 0 0 m l o f s o l u tio n ; 6 0 u n it s ( 6 m l) in 1 0 0 0 m l o f s o lu ti o n . L o w e r c o n c e n tr a tio n s ( lik e 1 0 - 2 0 u n its ) in 1 0 0 0 m l o f s o lu tio n m a y b e u s e d . D r u g m a y b e g iv e n in 1 0 - m in u te p u ls e d in fu s io n s r a t h e r t h a n c o n t in u o u s l y . S t a r tin g d o s e s o f 0 .5 t o 6 m ill iu n its , a n d in c r e a s in g d o s e s in 1 - to - 2 m illiu n it s /m i n in c r e m e n t s e v e r y 1 5 t o 4 0 m i n u t e s m a y b e p r o v id e d , d e p e n d in g o n th e p r o t o c o l f o llo w e d . C o n t r o l o f P o s t p a r t u m B l e e d in g : D ilu te 1 0 - 4 0 u n it s in 1 0 0 0 m l o f IV s o l u tio n . B e g in a t 2 0 - 4 0 m il liu n i ts /m in . I n c r e a s e a c c o r d in g to u t e r in e r e s p o n s e a n d r a te o f p o s t p a r t u m b le e d in g . IM - in je c t 1 0 u n its a f te r d e liv e r y o f p la c e n ta . N u r s i n g Im p lic a t io n s : - a s s e s s fe ta l h e a r t r a t e fo r a t le a s t 2 0 m in u te s b e f o r e in d u c t io n , - p e r f o r m L e o p o l d ’s m a n e u v e r o r v a g i n a l e x a m i n a t i o n ( o r b o t h ) t o v e r i f y c e p h a l i c fe t a l p r e s e n ta t io n . N o tif y p h y s ic ia n in c a s e o f n o c e p h a lic p r e s e n ta ti o n . - o b s e r v e u te r in e a c ti v i ty t o e s ta b lis h e ffe c ti v e la b o r p a t te r n ( c o n tr a c t io n e v e r y 2 3 m in u te s , d u r a tio n 4 0 - 9 0 s e c o n d s , i n te n s i ty 5 0 - 8 0 m m H g ) , - o b s e r v e f o r h y p e r t o n i c u te r in e a c t iv it y ( c o n tr a c t io n s le s s t h a n 2 m in u t e s a p a r t, R e s t in te r v a l s h o r te r th a n 3 0 s e c o n d s , d u r a t io n lo n g e r th a n 9 0 - 1 2 0 s e c o n d s , o r r e s ti n g to n e g r e a t e r th a n 2 0 m m H g ) , - o b s e r v e fe ta l h e a r t r a t e fo r t a c h y c a r d ia , b r a d y c a r d ia , d e c r e a s e d v a r ia b ilit y , a n d la t e d e c e le r a ti o n s , - If u te r in e h y p e r t o n ic i ty o c c u r s , n o t ify p h y s ic ia n . S to p o x y to c in , w o m a n in s id e ly in g p o s it io n , a d m in o x y g e n b y fa c e m a s k a t 8 - 1 0 L /m i n . R e c o r d m a tr n a l B P , p u ls e , a n d R R e v e r y 3 0 6 0 m i n u t e s , o r w it h e a c h d o s e in c r e a s e . - r e c o r d in t a k e a n d o u t p u t. M A G N E S IU M S U L F A T E IV C la s s if i c a t io n : m is c e lla n e o u s a n tic o n v u ls a n t . A c t io n : - d e c r e a s e s a c e t y lc h o lin e r e le a s e d b y m o t o r n e r v e im p u ls e s ( b lo c k s n e u r o m u s c u la r t r a n s m is s io n ) - d e p r e s s e s t h e C N S t o a c t a s a n a n...
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This note was uploaded on 11/08/2010 for the course NUR 2000 taught by Professor Rn during the Spring '10 term at Florida State College.

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