Summary NURSING NUR 2460C parent child exam 3 study guide with complete solution

NURSING NUR 2460C parent child exam 3 study guide with complete solution Chapter # 20 Pharmacologic Management Of Pain Describe use, administration, dose, onset action, adverse effect, contraindication systemic drugs promote pain relief during labor determining nursing care management woman labor & her fetus Systemic analgesia  Goal provide maximum pain relief with minimal risk  Alteration in maternal state affects fetus  Determine: women shouldnt have to be in pain in labor  Goal:Best effect mom without affecting baby to much  Note: all things mom gets affects baby Administration of systemic analgesia  When woman is uncomfortable  Well-established labor pattern  Contractions occurring regularly  Significant duration of contractions  Moderate to strong intensity  Pain medication before established labor is more likely to prolong labor. Maternal assessments  The woman is willing to receive medication  Vital signs are stable  Contraindications are not present  Info on other medications being administered  Maternal stress & pain more adverse then small amount of analgesia.  Explain Pharmacologic effects of medications.  Obtain consent for medications. Fetal assessments  Fetal heart rate between 110 & 160 bpm  Reactive nonstress test  Short-term variability is present  Long-term variability is average  Good HR Assessment of labor progress  Contraction pattern  Cervical dilatation  Fetal presenting part  Station of the fetal presenting part Nursing considerations  Record drug name, dose, route, site on EFM strip & chart  Record woman blood pressure & pulse (before and after) on EFM strip & chart  Safety precautions  raising of side rails  assessment of FHR Sedatives  Use: early latent phase  Purpose: relaxation & sleep Synthetic agonist-antagonist opioid agent  Butorphanol tartrate (Stadol)  Nalbuphine hydrochloride (Nubain)  Meperidine (Demerol) Butorphanol tartrate (Stadol)  Route: IM or IV  Dose: 1 to 2 mg IM or IV every 4 hours  Onset of action: If IV, onset rapid  Peak: 30 to 60 minutes  Duration: 3 to 4 hours  Maternal side effects: drowsiness, dizziness, fainting, hypotension  Neonatal side effects: respiratory depression Nubain  Route: IV (most common), IM, or subcutaneous  Dose: 10 to 20 mg  Onset of action: If IV, 2 to 3 minutes  Peak: 15 to 20 minutes  Duration: 3 to 6 hours (last longer)  Maternal adverse effects: respiratory depression, drowsiness  Fetal/neonatal effects: nonreassuring FHR, respiratory depression Meperidine (Demerol)  Route: IM or IV  Dose: IM—50 to 100 mg; IV—25 to 50 mg; every 1 to 2 hours  Maternal side effects—respiratory depression, constipation, dizziness, itching  Neonatal effects—neurobehavioral depression Fentanyl (sublimaze)  Route: IM or IV  Dose: 50 to 100 mcg every 2 hours  Onset of action: If IV, immediate; if IM, 7 to 15 minutes  Peak effect is 30 to 60 minutes  Duration: 30 to 60 minutes  Maternal side effects: hypotension, nausea, vomiting, respiratory depression  Neonatal side effects: less neurobehavioral depression