COLLEGE of Nursing

Alternative Related Learning Experience

NCM 109 High-Risk Mother
DRUG STUDY

Name: Robles, Kimberly A. BSN 2A- Group 1

NIFEDIPINE 10 mg OD po DRUG CALCULATIONS

MgSO4 1gm/hr for 24hrs (D5NM 1L + 20 gm of MgSO4 = 50 cc/hr MgSO4 1gm/hr for 24hrs (D5NM 1L + 20 gm of MgSO4 = 50 cc/hr (compute for gtts/min)
(compute for gtts/min)
IVF: Plain NSS 1L to run for 5-10 gtts/minute (Compute for the ml/hr)
NUBAIN 10mg IM 15 minutes prior to OR

VALUIM 10 mg IV 30 minutes prior to OR

IVF: Plain NSS 1 L to run for 5-10 gtts/minute (Compute for the
ml/hr)

GENERIC DRUG MECHANISM OF INDICATION ADVERSE NURSING

NAME/ BRAND CLASSIFICATION ACTION REACTIONS IMPLICATIONS
NAME

calcium-channel They work by preventing To treat severe hypertension  Maternal  Assess for anginal pain,
blockers calcium from entering in pregnancy and preterm tachycardia including location,
the cells of the heart and labour. Because it is given intensity, duration, and
arteries. Calcium causes  Palpitations
NIFEDIPINE in a tablet or capsule by alleviating and
the heart and arteries to mouth, it is easier to use aggravating factors.
 Flushing
Adalat, Afeditab squeeze (contract) more than intravenous drugs.
CR, Nifediac, strongly. By blocking  Headaches  Assess cardiac status
Nifedical, calcium, calcium channel with BP, pulse,
Procardia blockers allow blood  Dizziness respiration and ECG.
vessels to relax and open.
 Nausea  Ensure that patients do
not chew or divide
sustained-release
 tablets.
 Taper dosage of beta-
blockers before
nifedipine therapy.
 Protect drug from light
and moisture.

GENERIC NURSING
DRUG DRUG ADVERSE
NAME/ BRAND INDICATION
CLASSIFICATION CLASSIFICATION REACTIONS IMPLICATIONS
NAME

Antidysrhythmics, V It is used to utilized for  for women with pre-  Flushing  Check serum
prophylactic treatment in eclampsia for whom magnesium level prior
 increased warmth
all patients with severe there is concern about to administration.
MgSO4 preeclampsia. To trigger the risk of eclampsia  sweating due to the
 Cardiac monitor should
cerebral vasodilation, peripheral
Magnesium  first-line management be used on patients
thus reducing ischemia vasodilatory effects
Sulfate of an eclamptic receiving
generated by cerebral of magnesium
seizure MgSO4 intravenously
vasospasm during an
eclamptic event. The  Nausea & vomiting,
 first-line treatment of  Have injectable form of
substance also acts any seizure during  Headaches calcium gluconate
competitively in blocking pregnancy available to reverse
the entry of calcium into  Mmuscle weakness paralyzing effects of
synaptic endings, thereby  neuroprotection of
 Blurred vision magnesium sulfate.
altering neuromuscular preterm infants.
transmission.  Intravenous (IV) or  Blood pressure may
intramuscular (IM) drop if MgSO4 is
site pain or administered too
discomfort. rapidly.
 GENERIC DRUG DRUG INDICATION ADVERSE NURSING
NAME/ BRAND CLASSIFICATION CLASSIFICATION REACTIONS IMPLICATIONS
NAME

Synthetic The exact mechanism of Indicated for the  Abdominal pain  Do not recommend for
opioid agonist- action is unknown, but is management of pain severe  Depressed level or use in pregnant women
antagonist believed to interact with enough to require an opioid loss of during or immediately
an opiate receptor site in analgesic and for which consciousness prior to labor, when
the CNS (probably in or alternative treatments are  Tremor other analgesic
associated with the inadequate. NUBAIN can  Anxiety techniques are more
also be used as a  Pulmonary edema appropriate.
limbic system). The
supplement to balanced  Agitation  Assess respiratory rate
opiate antagonistic effect
anesthesia, for preoperative  Seizures before drug
may result from and postoperative analgesia,  injection site administration.
competitive inhibition at and for obstetrical analgesia reactions such as Withhold drug and
the opiate receptor, but during labor and delivery. pain, swelling, notify physician if
may also be a result of redness, burning, respiratory rate falls
other mechanisms. and hot sensations below 12.
 Watch for allergic
 Death has been response in persons
NUBAIN/ reported from with sulfite sensitivity.
Nalbuphine severe allergic  Administer with caution
reactions to to patients with hepatic
NUBAIN or renal impairment.
treatment.  Monitor ambulatory
patients; nalbuphine
may produce
drowsiness.
 Watch for respiratory
depression of newborn
if drug is used during
labor and delivery.
 GENERIC
DRUG MECHANISM OF ADVERSE NURSING
NAME/ BRAND INDICATION
CLASSIFICATION ACTION REACTIONS IMPLICATIONS
NAME

BENZODIAZEPIN Diazepam is a Useful in the symptomatic  Safe to take  Assess baseline vital
E and is a Schedule IV benzodiazepine management of mild to diazepam during signs.
controlled substance tranquilliser with moderate degrees of anxiety pregnancy but not
anticonvulsant, sedative, in conditions dominated by  Assess blood pressure,
during lactation
muscle relaxant and tension, excitation, pulse and respiration if
because it can
amnesic properties. agitation, fear, or IV administration.
cause lethargy,
aggressiveness such as may
sedation, and weight  Provide frequent sips
occur in psychoneurosis,
loss in infants. of water for dry mouth.
anxiety reactions due to
stress conditions, and SIDE EFECTS IN  Provide fluids and fibre
anxiety states with somatic NEWBORN for constipation.
expression.
 Sedation  Evaluate therapeutic
response, mental state
 Slowed breathing
VALUIM/ and physical
Diazepam  Withdrawal dependency after long-
term use.
 Problems feeding
Diastat, and PATIENT TEACHING
Diastat AcuDial SYMPTOMS
ASSOCIATED  Do not use for everyday
WITH VALIUM stress.
WITHDRAWAL CAN
 Do not use for more
INCLUDE:
than four months unless
 Headaches directed by a clinician.
 Nausea  Do not take more than
the prescribed dose.
 Vomiting
 Avoid non-prescribed
 Stomach pains
medications unless
 Cramps approved by a clinician.
 May cause drowsiness -
  Tremors avoid driving or any
other activities
 Increased blood
requiring alertness.
pressure
 Avoid other
 Increased heart rat
psychotropic
 Confusion medications unless
prescribed.
 Seizures
 Avoid alcohol.
 Mood swings
 Do not discontinue
 Rebound anxiety abruptly after long-term
 Drug cravings use - withdrawal
symptoms may occur.
 Rise slowly as fainting
may occur.
 Seek psychiatric help if
depressed.
 Store securely.

GENERIC DRUG MECHANISM OF INDICATION ADVERSE NURSING

NAME/ BRAND CLASSIFICATION ACTION REACTIONS IMPLICATIONS
NAME

Crystalloid Fluid Major cation of Extracellular fluid  Fever  Monitor for signs of
IVF: Plain extracellular fluid and replacement (e.g., fluid volume deficit,
NSS/ Sodium functions principally in dehydration, hypovolemia,  injection site such as confusion in
chloride injection hemorrhage, swelling, redness, or older adults and
the control of water
sepsis) Treatment of infection. dizziness.
distribution, fluid and
electrolyte balance and metabolic alkalosis in the  Never administer to
Normal Saline presence of fluid loss. Mild SERIOUS EFECTS patients at risk for
osmotic pressure of body
sodium depletion. increased ICP as the
fluids.  fast heartbeat potential fluid shift may
cause cerebral edema.
 fever  Document baseline
 rash vitalsigns, edema, lung
sounds, and heart
 joint pain sounds, and continue
monitoring during and
 shortness of breath. after the infusion.
 Monitor for continued
signs of hypovolemia,
including urine output <
0.5 mL/kg/hour, poor
skin turgor, tachycardia,
weak pulse, and
hypotension.
 College of Nursing
Alternative Related Learning Experience
NCM 109 High-Risk Mother
LABORATORY TESTS
Name: Robles, Kimberly A.
Research on the following laboratory Test for High Risk Mother. Give the indication and preparation of the given diagnostic procedures.
Laboratory Procedure Indication
 an ultrasound scan taken by a probe inserted into
the vagina. It gives a clear picture of the fetus,
cervix and placenta. It is also called an internal
ultrasound or a transvaginal ultrasound.
 medical ultrasonography that applies an
ultrasound transducer in the vagina to visualize
organs within the pelvic cavity. It is also called
transvaginal ultrasonography because the
ultrasound waves go across the vaginal wall to
study tissues beyond it.
1. VAGINAL ULTRASOUND
Patient Preparation
 your care provider may ask that you not eat or drink
for a certain period of time before the exam.
 Do not empty your bladder until after the exam.
 Generally, no fasting or sedation is required for a
pelvic ultrasound, unless the ultrasound is part of
another procedure that requires anesthesia.
 You do NOT need a full bladder for this scan.
 You'll undress from the waist down and put your feet
up in stirrups
 Perform proper hand washing and Wear clean glove
 The technician will cover the transducer with a
condom-like sheath and lubricant before placing it
inside your vagina.
 Apply specific gel.
 ALT TEST
 A higher result than typical on this test can be a
sign of liver damage.
 Very high levels over 1,000 units per liter (U/L)
are most often caused by viral hepatitis, ischemic 
hepatitis, or injury from drugs or other chemicals.
 Wear a shirt with sleeves that can easily be rolled up
AST TEST
 A high result on an AST test might indicate a
2. LIVER FUNCTION TEST
problem with your liver or muscles. Elevated AST
(ALT, AST) without elevated ALT may indicate heart or
muscle disease. If ALT, bilirubin, and ALP are also
elevated, it may indicate liver damage.
 Doctor will give you complete instructions on how to
prepare for the blood sample portion of the test.
 Do not eat or take c ertain medications and foods
may affect levels of these enzymes and proteins in
your blood.
Be sure to continue drinking water prior to the test.
to make it easier for the medical expert to collect the
blood sample.
HOW IT IS PERFORMED:
 The healthcare provider will clean your skin before
the test to decrease the likelihood that any
microorganisms on your skin will cause an infection.
 They’ll likely wrap an elastic strap on your arm. This
will help your veins become more visible. They’ll
then use a needle to draw samples of blood from your
arm.
 After the draw, the health care provider will place
some gauze and a bandage over the puncture site.
Your blood sample will be sent to a laboratory for
testing.