Baptist Health School of Nursing
NSG 3016A Women’s Health
Nursing Process as Related to the Administration
of Medications to Women and Newborns
Kathy Marcussen, RNC, MSN
Lecture Objectives:
1.
2.
3.
4.
5.
Discuss medication-related physiologic concerns during pregnancy.
Apply understanding of physiologic changes, placental function, effect on fetus, and
mechanism of transfer to breast milk to patient care and education.
Apply principles of pharmacology and obstetric implications in providing nursing care
for women and newborns.
Utilize required information to provide safe administration of listed medications.
Perform accurate medication dosage and flow rate calculations.
Reading Assignment:
Wong, pages 448-464
Lilley, pages 36-38
Davis, drugs as listed
Lecture Outline:
I.
Drug therapy during pregnancy and breastfeeding
A.
Pharmacokinetics
1.
Physiologic changes in pregnancy
2.
Placental transfer of drugs
3.
Adverse effect of meds on the fetus
4.
Drug transfer in breast milk
B.
Clinical Implications - risk/benefit
C.
Nursing Implications
II.
Medication Administration in Obstetrics
(As applied to selected drugs)
A.
Drug Classification, specific to OB patient situation
B.
Trade and Generic Names
C.
Available routes of administration for OB patients
D.
Prescribed dose and recommended dose range
E.
Patient-specific indication for use (OB)
F.
Adverse reactions and side effects
G.
Pharmacodynamics - for OB
1.
Mechanism of onset
H.
I.
III.
2.
Onset
3.
Peak
4.
Duration
5.
Half-life
Contraindications/major interactions, especially in pregnancy
Nursing Considerations and Implications
1.
Fetus
2.
Laboring patient
3.
Neonate
4.
Postpartum patient
5.
Gynecology patient
Medications:
terbutaline (Brethine)
betamethasone (Celestone)
ampicillin
dinoprostone (Cervidil)
misoprostol (Cytotec)
oxytocin (Pitocin)
butorphanol (Stadol)
morphine sulfate
fentanyl
bupivicaine (Marcaine)
naloxone (Narcan)
lidocaine (Xylocaine)
methylergonovine (Methergine)
carboprost (Hemabate)
erythromycin ointment (Ilotycin)
phytonadione (Vitamin K, AQUAmephyton)
magnesium sulfate
hydralazine (Apresoline)
labetalol (Normodyne)
calcium gluconate
oxycodone/apap (Percocet)
Rho(D)immune globulin (RhoGam)
IV.
Example:
When studying butorphanol (Stadol), consider how its administration during labor will
effect the fetus...decrease in fetal heart variability, anticipate respiratory depression when
the fetus is delivered. Neonatal narcan... How will it effect the mom if given postpartum?
Sedation, sleepiness, unsteady when ambulating, constipation a risk. And the breastfed
neonate? Sleepy, difficult to awake for feeding, poor feeder.