what teaching would the nurse include for a pt newly prescribed estrogen?
No smoking, monthly breast exam, biopsy q 2 yrs if postmenopausal
Report pain/tenderness/swelling in legs/persistent bleeding/short of breath/chest pain
Take med at same time each day
Transdermal patch applied to skin of trunk NOT breast/waistline
d/c pri
what are some uses for estrogen?
Contraception, postmen sx, prevent osteoporisis, tx dysfunctional uterine bleeding, tx prostate cancer and vulvar atrophy
what are some uses for progesterones?
paired w/ estrogen for contraception
hormonal imbalance (amenorrhea/dysfunctional bleeding)
endometriosis
cancer of the endometrium, breast, or kidney
in-vitro and prevent preterm birth
what are some adverse effects of progesterones the pt should be aware of?
breast cancer, thromboembolic events, breakthrough bleeding, amenorrhea, edema, jaundice, migraines
what are some meds that will decrease the effectiveness of medroxyprogesterone?
carbamazepine, phenobarbital, phenytoin, rifampin
bromocriptine use can cause amenorrhea
what pt teaching should the nurse provide when her pt is d/c norethindrone?
anticipate withdrawl bleeding 3-7 days
after stopping med
stop taking med immediately if pregnant
delay conception for 3 months following d/c
what are some adverse effects of ethinyl estradiol/ drospirenone OCs the pt should be aware of?
Clots, HTN, breakthrough bleeding, breast cancer
what is some teaching the nurse will provide for the client who has missed a pill?
1 missed dose - 2 together on next dose
2 missed - double up for 2 days
3 missed - use alternate birth control and start a new cycle of pills after waiting 7 days
what is some teaching the nurse will provide for extended cycle OCs?
Seasonale - take med for 84 days; will have withdrawl bleeding 4x/yr
Lybrel - take med continuously; will NOT have withdrawl bleeding
what are adverse effects of testosterone the client should be aware of?
women - irregular menses, hirtutism, weight gain, acne, voice deepening, growth of clitoris, vaginitis, baldness
men - acne, priapism, increased body hair, penile enlargement
epiphyseal closure, cholestatic hepatitis, jaundice, hypercholesterolemia (raise
testosterone is contraindicated for which pts?
breast cancer, hypercalcemia, older adults
what labs will the nurse MR for the pt taking testosterone?
PT, INR, glucose, liver enzymes
what teaching will the nurse provide r/t a new finasteride prescription?
effects may take up to 6 mo
pregnant women should NOT handle crushed or broken meds
do NOT donate blood for at least 1 month after d/c med
what will the nurse MR when her pt begins taking tamusolin?
BP at start of therapy and when changing dose
sildenafil is contraindicated for which client?
pts taking any type of nitrate
what are some uses for oxytocin?
induction of labor, enhancement of labor, delivery of placenta, tx postpartum hemorrhage, stress testing
why would a pt be prescribed dinoprostone?
promote cervical ripening or stimulate uterine contxn
why would a pt be prescribed methylergonovine?
emergency intervention for serious postpartum hemorrhage
Contra for HTN pts; mother should not breastfeed for 12 hours after last dose
what will the nurse have on hand when her pt has been given oxytocin?
Mg sulfate
what are contraindications for oxytocin admin?
maternal: sepsis, unripe cervix, genital herpes, hx multiple births/uterine surgery
fetal: immature lungs, disproportion, malpresentation, prolapsed cord, fetal distress, threatened spontaneous abortion
what will the nurse MR for her pt on oxytocin?
BP and pulse rate
Monitor cntxns for frequency/duration
STOP infusion if cntxn lasts longer than 1 minute, occurs more often than q 2-3 min, or uterine pressure > 15 mm Hg
what will the nurse MR after admin of terbutaline sulfate?
FHR, uterine cntxn, BP, respiration, lung sounds, daily weight
d/c med if pt reports chest pain, maternal HR > 120, cardiac arrhythmia
Limit fluid intake 1500-2400 ml/day
what are 4 meds that treat preterm labor?
hydroxyprogesterone caproate, nifedipine, mg sulfate, indomethacin
which med treats preeclampsia?
mg sulfate
what are some sx of mg sulfate the nurse will watch for?
loss of deep tendon reflex, urine output < 25-30 ml/hr, resp < 12, pulmonary edema, chest pain
Ca gluconate admin for mg sulfate toxicity
what meds may be admin for pain during labor?
meperdine hydrochloride (risk resp depression)
butorphanol and nalbuphine do NOT cause significant resp depression to mother or fetus