Student Name

:

Tennille Gore

Pt Initials: Pt Allergies:

AM PCN

M/B (Post-partum) Medication List

Drug (Generic, Trade and Class)

Dosage/Ro ute/ Frequency

Rationale

Side Effects/ Nursing Implications Dizziness, headache, tinnitus, dyspnea, hypotension, palpitations, nausea, vomiting, cramps, diaphoresis, allergic reactions. Monitor blood pressure, heart rate, and uterine response frequently during medication administration. Notify physician or other health care professional promptly if uterine relaxation becomes prolonged or if character of vaginal bleeding changes. Asses for signs of ergotism (cold, numb fingers and toes, chest pain, nausea, vomiting, headache, muscle pain, weakness). Lab Test Considerations: If no response, calcium levels may need to be assessed. Effectiveness of medication is decreased with hypocalcemia. May cause decrease serum prolactin levels.

Methylergonovin 200400mcg / e
Methergine Classification(s) Therapeutic: oxytocic Pharmacologic: ergot alkaloids Pregnancy Category C

PO / Q6-12 H / 2-7 Days 200mcg / IM / IV / Q2-4 H / up to 5X IV administrat ion is used for emergencie s only.

Prevention and treatment of postpartum or post-abortion hemorrhage caused by uterine atony or subinvolution.

Oxycodone/ Acetaminophen
Endocet, Oxycocet, Percocet, PercocetDemi, Roxicet, Roxilox, Tylox Classification(s) Therapeutic: opioid analgesics (in combination with nonopioid analgesic) Schedule II Pregnancy Category C (oxycodone)

1-2 Tab / PO / PRN / Q4-6 H

Management of moderate to severe pain.

*High Alert* Confusion, sedation, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams, blurred vision, diplopia, miosis, respiratory depression, orthostatic hypotension, bradycardia, constipation, dry mouth, nausea, vomiting, urinary retention, flushing, sweating, physical dependence, psychological dependence, tolerance. Assess type, location, and intensity of pain prior to and 1 hr (peak) after administration. When titrating opioid doses, increases of 25-50% should be administered until there is either a 50% reduction in the patient’s pain rating on a numerical or visual analog scale or the patient reports satisfactory pain relief. A repeat dose can be safely administered at the time of the peak if previous dose is ineffective and side effects are minimal. Assess blood pressure, pulse, and respirations before and periodically during administration. If respiratory rate is <10/min, assess level of sedation. Physical stimulation may be sufficient to prevent significant hypoventilation. Dose may need to be decreased by 25-50%. Initial drowsiness will diminish with continued use. Prolonged use may lead to physical and psychological dependence and tolerance. This should not prevent patient from receiving adequate analgesia. Most patients who receive oxycodone for pain do not develop psychological dependence. Progressively higher doses may be required to relieve pain with long-term therapy. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk, and laxatives to minimize constipating effects. Stimulant laxatives should be administered routinely if opioid use exceeds 2-3 days, unless contraindicated. Lab Test Considerations: May increase plasma amylase and lipase levels. Toxicity and Overdose: If an opioid antagonist is required to reverse respiratory depression or coma, naloxone (Narcan) is the antidote. Dilute the 0.4-mg ampule of naloxone in 10 ml of 0.9% NaCl and administer 0.5 ml (0.02 mg) by direct IV push every 2 min. For children and patients weighing <40 kg, dilute 0.1 mg of naloxone in 10 ml of 0.9% NaCl for a concentration of 10 mcg/ml and administer 0.5 mcg/kg every 2 min. Titrate dose to avoid withdrawal, seizures, and severe pain. Max dose from all sources not to exceed 4000mg per 24 hours