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Postpartum and Newborn Drugs

Postpartum and Newborn Drugs. Dena Evans, EdD(c), MPH, BSN, RN, CNE Assistant Professor Department of Nursing The University of North Carolina at Pembroke. Postpartum. See Routine Orders pg. 857. Five Purposes. Prevent uterine atony Relive pain Enhance or suppress lactation

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Postpartum and Newborn Drugs

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  1. Postpartum and Newborn Drugs Dena Evans, EdD(c), MPH, BSN, RN, CNE Assistant Professor Department of Nursing The University of North Carolina at Pembroke

  2. Postpartum See Routine Orders pg. 857

  3. Five Purposes Prevent uterine atony Relive pain Enhance or suppress lactation Promote bowel function Enhance immunity

  4. Pain Relief • NSAIDS • May prolong bleeding time • Take with food or water ↓ GI upset • Narcotics

  5. Remember • Systemic analgesics • Decreased alertness • Opioids • Bowel function • Respirations

  6. Perineal Wounds and Hemorrhoids

  7. REEDA Redness Ecchymosis Edema Discharge Approximation

  8. Medications • Witch hazel • Nupercainal onitment • Nonpharmacological • Sitz baths

  9. Lactation Suppression • Medications not used/less popular due to side effects • Chlorotrianisene (Tace) • Deladumone OB • Bromocriptine mesylate (Parlodel) • You may be asked about these by a family member • Now-support bras, breast bindings, axillary ice packs

  10. Bowel Function • Flatus • Antiflatulants • Ambulation • Increase water intake • High-fiber foods

  11. Bowel Function Colace Peri-Colace Dulcolax MOM Mineral Oil Nursing Process Laxatives-pg. 864

  12. Immunizations Rho D Immune Globulin Explain erythroblastosis fetalis Direct vs. Indirect Coomb’s test

  13. RhoD • Given prenatally in approx. 1-2% of Rh- women. • Assessed at initial prenatal visit and again at 28-29 weeks. • Can be given IM within 72 hours after delivery • Routinely given after maternal/fetal blood mixing. • Human D immunoglobulin • Religious Beliefs**

  14. Rubella Vaccine AKA German Measles High rate of abortion, neurological defects Congenital rubella syndrome First Trimester-risk After First Trimester-less risk Vaccine is contraindicated during pregnancy

  15. Side Effects Burning at injection site acidic pH of vaccine. Urticaria-allergic reaction Malaise Fever Headache Arthralgia Moderate fever

  16. Adverse Reactions Hypotension Chills Dizziness Headache Pruritis Injection site reaction Have epinephrine available to treat anaphylaxis

  17. Newborn Immediately After Delivery

  18. After Delivery-Newborn • Erythromycin Ophthalmic Ointment • Vitamin K • Anti-infective agents (cord stump) • Literature supports drug cord care

  19. Side Effects/Adverse Reactions • EES-chemical conjunctivitis • Vitamin K-prevents bleeding • Pain and edema at injection site • Allergic reaction • Hyperbilirubinemia and jaundice • Bilirubin and Vitamin K = protein binding sites

  20. Discharge Immunizations • HBV • Require maternal consent (signed) • Number based on mothers HBsAg status • IM-vastus lateralis (preferred site) or rectus femoris • Negative-only one injection • Positive-two • HBV vaccine AND HBIG (hepatitis B immune globulin)

  21. Nursing Process HBV Page 872

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