DRUG STUDY
NAME OF DOSE/
DRUG
FREQUENCY
GENERIC
(BRAND)
Oxytocin 0.5 to 1 milliunits/minute
(Pitocin) given by intravenous
injection and increased by 1
to 2 milliunits/minute every
15 to 60 minutes (inducing
labor)
10 units by injection at a
rate of 20 to 40
milliunits/minute.
(controlling bleeding)
10 to 20 milliunits/minute
not to exceed 30 units in a
12-hour period. (inevitable
abortion)
Intramuscularly
Methergine
1 mL, 0.2 mg, after delivery
of the anterior shoulder,
after delivery of the
SIDE NURSING PRECAUTIONS
INDICATION CONTRAINDICATIONS EFFECTS
Initiation or improvement High blood pressure Nausea During oxytocin
of uterine contractions to administration, uterine
achieve early vaginal Placenta Previa Vomiting
contractions, fetal and
delivery for maternal or Single pregnancy with more Severe allergic reactions maternal heart rate, maternal
fetal response (IV). than one child blood pressure, and, if
Bleeding after child birth possible, intrauterine pressure
As adjunctive therapy in Previous C Section
Abnormal heart beats should be continuously
the management of
Given Birth to Six or more monitored to avoid
inevitable or incomplete High blood pressure
abortion (IV) Children complications.
Rupture of the uterus
Malposition or
Stimulation of uterine
malpresentation of Fetus
contrarians during third
stage of labor (IV) Fetal Distress
Control of postpartum
bleeding or hemorrhage
(IV,IM)
Prevention and treatment of Blockage or narrowing of Nausea If contractions are less than 2
postpartum and post mitral heart valve minutes apart, if they’re above
Vomiting
abortion, hemorrhage 50mm Hg ,or if they last
High blood pressure
caused by uterine atony or Stomach pain 90seconds or longer, stop
 placenta, or during the
puerperium. May be
repeated as required, at
intervals of 2-4 hours.
Intravenously
1 mL, 0.2 mg, administered
slowly over a period of no
less than 60 seconds
Orally
One tablet, 0.2 mg, 3 or 4
times daily in the
puerperium for a maximum
of 1 week.
sub-involution Heart attack Diarrhea infusion, and turn patient on
her side, and notify prescriber
Coronary artery disease Leg cramps
Stroke Increased sweating
Arteriosclerosis with Skin rash
occlusion of the arteries
Headache
Serious numbness or
prickling or tingling of
fingers and toes
Liver problems

Lidocaine Local Injectable Local or regional Hypersensitivity Adverse reactions: When Lidocaine is
Anesthesia anesthetic. administered as an
Advanced AV block Drowsiness antiarrhythmic the nurse
Management of acute
Maximum individual should monitor the ECG
ventricular arrhythmias Dizziness
dose: 4mg/kg (IV continuously. Blood pressure
during cardiac
regional anesthesia); Nervousness and respiratory status should
manipulation. Control
4.5mg/kg (infiltration) be monitored frequently
of status epilepticus (Mucosal use) decreased during the drug
Maximum total dose: refractory to other or absent of gag reflex administration.
300 mg treatments
Bradycardia
When administered as an
Hypotension anesthetic, the numbness of
the affected part should be
 Burning sensation assessed.

Serum lidocaine levels should

be monitored frequently
during prolonged use.
Therapeutic serum lidocaine
levels range from 1.5 to 5
mcg/ml

If signs of overdose occur

stop the infusion immediately
and monitor the patient
closely.

Hepa B Intramuscular The recommended 3-dose History of allergic reaction Body Whole: Assessment & Drug Effects
suspension regimen produces active to hepatitis B vaccine or to
Mild local tenderness at Note: The ACIP recommends
(pediatric/adolescent immunity against hepatitis any ingredient in the
injection site serologic confirmation of post
formulation) B infection by inducing formulation; HBsAg
protective antibody (anti- carriers. Safe use during Local inflammatory vaccination immunity in
5 mcg/0.5 ml patients undergoing dialysis
HBs) formation. pregnancy (category C) and reaction (swelling, heat,
(Recombivax HB) and in immune deficient
lactation is not established. redness, in duration, pain)
patients.
10 mcg/0.5 mg (Engerix Monitor temperature. Some
Fever
B) patients develop a temperature
Malaise elevation of 38.3° C (101° F)
following vaccination that
Fatigue
may last 1 or 2 d.
Headache
Patient & Family Education
Dizziness
Learn potential adverse
Faintness
reaction.
Leg cramps Do not breast feed while
 Myalgia taking this drug without
consulting physician.
Arthralgia
GI:
Nausea
Vomiting
Diarrhea
Skin:
Rash
Urticari
Pruritus

Vitamin K Intramuscular injection Vitamin K compounds are Hypersensitivity to any Pain and edema may occur Document the giving of the
is given in the vastus use in the treatment and component of this at injection site. Allergic medication to newborn to
lateralis thigh muscle. prevent of hemorrhage medication. reaction such as rash and prevent an accidental
associated with Vitamin k urticaria, may also occur. doubling of the dose.
A onetime only Observe for bleeding (usually
deficiency.
prophylactic dose of 0.5 occurs on second or third
to 1 mg is given day).
intramuscularly in the Bleeding may be seen as
birthing area within 1 generalized ecchymoses or
hour of birth. bleeding from umbilical cord,
circumcision site, nose or
gastrointestinal tract.
Observe for jaundice and
kernicterus, especially in
preterm infants.
Observe for signs of local
inflammation.

Erythromycin Topical administration:
2% ointment (Apply 0.5-1
opthalmia neonatorum.
cm ribbon in lower
conjunctival sacs shortly
after birth)
Apply pressure to the
injection site to prevent
further bleeding
Protect drug from light.
Give vitamin K before
circumcision procedure.
To prevent neonatal Hypersensitivity Rash History:
conjunctivitis and Allergy to erythromycin,
Porphyria hepatic Urticaria hepatic impairment, lactation;
impairment viral, fungal, mycobacterial
Nausea & vomiting
infections of the eye
Pregnancy
GI discomfort (ophthalmologic), pregnancy
Ototoxicity Physical:
Central neurotoxicity Site of infection; skin color,
lesions; orientation, affect,
Agranulocytosis hearing tests; R, adventitious
sounds; GI output, bowel
Arrhythmias sounds, liver evaluation;
Pancreatitis culture and sensitivity tests of
infection, urinalysis, LFTs
Potentially Fatal:
Hepatotoxicity
Cholestatic jaundice
Raised serum
transaminases
Eosinophilia
 NURSING CARE PLAN
DURING LABOR

CUES NURSING OBJECTIVES/ NURSING RATIONALE EVALUATION

DIAGNOSIS INTERVENTION
EVALUATION
CRITERIA
Subjective Labor pain related Within 2 hours of 1. Asses stage of labor. 1. Choice and timing of After 2 hours of nursing
to cervical nursing intervention medication is affected by intervention, the client
“Sakit na gyud kayo mam”
dilatation the client will be degree of dilatation and was able to participate
2. Evaluate degree of
“Kalibangon na kayo ko” able to participate in discomfort through contractile pattern. in decision-making for
decision-making for verbal and nonverbal pain management plan
Objective 2. Attitudes and reactions to p
pain management cues. that includes personal
ain are individual and based to
- Fast shallow plan to include preferences and cultural
past experiences,
breathing personal preferences 3. Determine availability beliefs.
understanding of physiological
- Guarding behaviour and cultural beliefs. and preparation of
changes and familial/cultural
- Grimace support persons.
expectations.
- Squinting
3. Presence of a supportive
4. Encourage use of
comfort measures. partner, family/ friend can
provide emotional support and
5. Assess client’s desire enhance level of comfort.
for physical touch 4. Promotes relaxation.
during contractions.
5. Touch may serve as a
6. Coach use of distraction, provide supportive
appropriate breathing reassurance and
exercises/relaxation encouragement, and may aid in
techniques and maintaining sense of control
 abdominal effleurage and reducing pain.
based on the stage of
labor. 6. May block pain impulses
7. Recommend client within the cerebral cortex
void every 1-2 hours. through conditioned responses
8. Provide for a quiet and cutaneous stimulation and
environment that is gives the client a means of
adequately ventilated, coping with and controlling the
dimly lit, and free of level of discomfort.
unnecessary personnel.
9. Offer encouragement, 7. Reduces bladder distention
provide information which can increase discomfort
about labor progress, and prolong labor.
and provide positive
reinforcement for 8. Nondistracting environment
client’s/couple’s provides optimal opportunity
efforts. for rest and relaxation between
10. Note perineal bulging contractions.
or vaginal show.
9. Provides emotional support
which can reduce fear, lower
anxiety levels, and help
minimize pain.
10. Discomfort levels increase
as cervix dilates, fetus
descends, and small blood
vessels rupture.
 NURSING CARE PLAN
POSTPARTUM

CUES NURSING OBJECTIVES/ NURSING RATIONALE EVALUATION

DIAGNOSIS INTERVENTION
EVALUATION
CRITERIA
Subjective Acute pain related Within 2 hours of 1. Assess for referred 1. To help determine After 2 hours of nursing
to surgical incision nursing intervention pain. possibility of intervention client was
“Sakit sakit pa mam kay 2. Monitor vital underlying conditions.
(episiotomy). the client will be able to report that pain
bag-o pa, sakit pa ilihok signs. 2. To provide baseline
able to report pain is is controlled as
lihok” 3. Accept client’s data.
relieved or evidenced by the pain
controlled. description of pain. 3. Pain is a subjective score of 3/10 from 5/10.
Objective
4. Evaluate pain experience and cannot
- Guarding behaviour characteristics and be felt by others.
- Grimace intensity using 0- 4. To determine the level
- Squinting 10 pain scale and intensity of pain.
- Pain scale of 5/10 rating. 5. This is to prevent lung
5. Encourage deep problems.
breathing 6. Observations may not
exercises. be congruent with
6. Observe nonverbal verbal reports.
cues. 7. To evaluate coping
7. Encourage abilities and to identify
verbalization of areas of additional
feelings about the concern.
pain. 8. To prevent fatigue that
8. Encourage can impair ability to
adequate rest manage or cope with
periods. pain.
9. Note client’s age 9. Affecting ability to
and developmental report pain parameters.
level and current 10. Provides baseline for
condition. interventions and
10. Assess client’s teaching provides
knowledge of and opportunity to allay
expectations about common fears and
pain management. misconceptions.