Podcast
Questions and Answers
What is a potential effect of rapid IV administration of fentanyl citrate?
What is a potential effect of rapid IV administration of fentanyl citrate?
- Increased heart rate
- Nausea and vomiting
- Enhanced cognitive function
- Muscle rigidity (correct)
What should be monitored in neonates whose mothers received fentanyl during labor?
What should be monitored in neonates whose mothers received fentanyl during labor?
- Enhanced physical strength
- Respiratory depression (correct)
- Hyperactivity
- Increased appetite
Which herbal supplements may increase CNS depression when used with fentanyl?
Which herbal supplements may increase CNS depression when used with fentanyl?
- Ginseng and valerian root
- Ginger and garlic
- Echinacea and elderberry
- St John's wort, kava kava, and gotu kola (correct)
What indicates a possible withdrawal symptom in a neonate?
What indicates a possible withdrawal symptom in a neonate?
What is the recommended administration duration for fentanyl citrate via IM/IV?
What is the recommended administration duration for fentanyl citrate via IM/IV?
Which class of drugs should be used cautiously with fentanyl due to overdose risk?
Which class of drugs should be used cautiously with fentanyl due to overdose risk?
What is the dosage range for fentanyl citrate when administered via IM/IV?
What is the dosage range for fentanyl citrate when administered via IM/IV?
What consequence is associated with the interaction of fentanyl and frequent CNS depressant usage?
What consequence is associated with the interaction of fentanyl and frequent CNS depressant usage?
What is a potential effect of administering certain medications during labor?
What is a potential effect of administering certain medications during labor?
Which condition is NOT a contraindication for certain labor induction methods?
Which condition is NOT a contraindication for certain labor induction methods?
What is one of the mechanical methods for labor induction?
What is one of the mechanical methods for labor induction?
What happens when a 36F indwelling catheter is inserted through the cervix?
What happens when a 36F indwelling catheter is inserted through the cervix?
Which is a false statement regarding prostaglandins used in labor induction?
Which is a false statement regarding prostaglandins used in labor induction?
Intrauterine growth retardation is associated with which of the following?
Intrauterine growth retardation is associated with which of the following?
What is the role of the balloon in the second mechanical method for labor induction?
What is the role of the balloon in the second mechanical method for labor induction?
Which condition is characterized by documented fetal intolerance of uterine contractions?
Which condition is characterized by documented fetal intolerance of uterine contractions?
What is the recommended observation time for the patient after administering Oxytocin?
What is the recommended observation time for the patient after administering Oxytocin?
What is the initial dose for intravaginal medication to ripen an unfavorable cervix?
What is the initial dose for intravaginal medication to ripen an unfavorable cervix?
What should be assessed prior to the insertion of the cervical ripening agent?
What should be assessed prior to the insertion of the cervical ripening agent?
Which complication requires monitoring after the insertion of the medication?
Which complication requires monitoring after the insertion of the medication?
What is a common gastrointestinal side effect of the cervical ripening medication?
What is a common gastrointestinal side effect of the cervical ripening medication?
What is the maximum dosage of dinoprostone that can be administered for labor induction?
What is the maximum dosage of dinoprostone that can be administered for labor induction?
How long should a patient remain recumbent after the administration of gel?
How long should a patient remain recumbent after the administration of gel?
What is the recommended time frame for sequential use of oxytocin after gel administration?
What is the recommended time frame for sequential use of oxytocin after gel administration?
What are the characteristics of the dinoprostone vaginal insert for labor induction?
What are the characteristics of the dinoprostone vaginal insert for labor induction?
What is the appropriate action if a patient experiences uterine hyperstimulation after administration?
What is the appropriate action if a patient experiences uterine hyperstimulation after administration?
What is the proper technique for administering dinoprostone vaginal inserts?
What is the proper technique for administering dinoprostone vaginal inserts?
How long should the dinoprostone vaginal insert be left in place during labor induction?
How long should the dinoprostone vaginal insert be left in place during labor induction?
Which is NOT recommended regarding the placement of the dinoprostone insert?
Which is NOT recommended regarding the placement of the dinoprostone insert?
What is the recommended route and dosage of beractant for an infant?
What is the recommended route and dosage of beractant for an infant?
What precaution should be taken when preparing beractant for administration?
What precaution should be taken when preparing beractant for administration?
When should the prophylactic dose of beractant ideally be given?
When should the prophylactic dose of beractant ideally be given?
How many maximum doses of beractant can be given to an infant in 48 hours?
How many maximum doses of beractant can be given to an infant in 48 hours?
At what temperature should beractant be stored?
At what temperature should beractant be stored?
What should be monitored following the administration of beractant?
What should be monitored following the administration of beractant?
What is the appearance of a properly prepared beractant dose?
What is the appearance of a properly prepared beractant dose?
What is important about warming the beractant vial before use?
What is important about warming the beractant vial before use?
Study Notes
Fentanyl Citrate (Sublimaze)
- Administer via IM/IV in doses of 50-100 mcg.
- Caution: Rapid IV administration may cause muscle rigidity.
- Monitor neonates for respiratory depression if the mother received this drug during labor.
- Withdrawal symptoms may occur in neonates from maternal opioid use during pregnancy.
- Risk of overdose increases with concurrent use of CNS depressants, phenothiazines, ethanol, and tricyclic antidepressants.
- Herbal interactions include heightened CNS depression with St. John’s wort, kava kava, and gotu kola.
- Potential side effects: drowsiness, respiratory depression, sedation, euphoria, hallucinations, headache, palpitations, and monitor respiratory rate.
Labor Induction Contraindications
- Documented fetal intolerance of uterine contractions.
- Conditions: chorioamnionitis, prematurity, postdates (>42 weeks), placenta previa, suspected abruptio placentae, severe gestational hypertension.
- Additional factors: intrauterine growth retardation, maternal diabetes (classes B-F), multifetal gestation, isoimmunization, and history of uterine trauma.
Approaches to Labor Induction
- Methods include mechanical techniques and prostaglandins.
Mechanical Methods
- Involves the use of a 36F indwelling catheter inserted through an undilated cervix, followed by balloon inflation.
- The bulb of the catheter mimics membrane stripping. Once expelled, initiate IV oxytocin.
- Another method includes extraamniotic saline infusion via a catheter to induce labor.
- Membrane stripping releases prostaglandins, enhancing the uterine response.
Prostaglandin Use
- Prepidil (dinoprostone) may be inserted intravaginally; max dose is 1.5 mg, supplied in three doses.
- Administration requires sterile technique; monitor for uterine hyperstimulation.
- Assess cervical dilation and effacement post-insertion.
Beractant (Survanta)
- Administer 4 mL/kg via ET, divided into four doses.
- Monitor infant’s arterial or transcutaneous oxygen and carbon dioxide levels.
- Store at 36° to 46°F (2°-8°C); warm before use but do not shake or artificially warm.
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Description
Test your knowledge on narcotic agonists including fentanyl citrate and other herbal supplements. This quiz covers key points regarding their uses, administration routes, and potential side effects. Prepare to understand the implications of rapid IV administration and muscle rigidity.
