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Postpartum and Newborn Drugs

Postpartum. See Routine Orders pg. 857. Five Purposes. Prevent uterine atonyRelive painEnhance or suppress lactationPromote bowel functionEnhance immunity. Pain Relief. NSAIDSMay prolong bleeding timeTake with food or water ? GI upsetNarcotics. Remember. Systemic analgesicsDecreased alertnes

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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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