Postpartum Nursery Medications PDF

**Ondansetron (Zofran)** - **Route(s):** PO, IM, IV - **OB Indications:** Nausea/vomiting in labor and postpartum - **Contraindications:** Hypersensitivity to ondansetron - **Side Effects:** Headache, dizziness, constipation - **Nursing Considerations:** Monitor for QT prolongation in...

**Ondansetron (Zofran)** - **Route(s):** PO, IM, IV - **OB Indications:** Nausea/vomiting in labor and postpartum - **Contraindications:** Hypersensitivity to ondansetron - **Side Effects:** Headache, dizziness, constipation - **Nursing Considerations:** Monitor for QT prolongation in high doses - **Client Teaching:** Can be taken with or without food; report severe dizziness **Carboprost (Hemabate)** - **Route(s):** IM - **OB Indications:** Postpartum hemorrhage due to uterine atony - **Contraindications:** Asthma, pelvic inflammatory disease - **Side Effects:** Nausea, vomiting, diarrhea, fever - **Nursing Considerations:** Monitor for excessive diarrhea; use cautiously in patients with hypertension - **Client Teaching:** Expect flu-like symptoms; notify provider of severe cramping **Methylergonovine (Methergine)** - **Route(s):** IM, PO - **OB Indications:** Prevention/treatment of postpartum hemorrhage due to uterine atony or subinvolution - **Contraindications:** Hypertension, preeclampsia - **Side Effects:** Hypertension, nausea, headache - **Nursing Considerations:** Monitor blood pressure closely - **Client Teaching:** Take at the same time each day if prescribed orally **Docusate Sodium** - **Route(s):** PO - **OB Indications:** Stool softener to prevent constipation postpartum - **Contraindications:** Bowel obstruction, undiagnosed abdominal pain - **Side Effects:** Mild cramping, diarrhea - **Nursing Considerations:** Encourage fluid intake for effectiveness - **Client Teaching:** Do not take with mineral oil; increase fiber intake **Simethicone** - **Route(s):** PO - **OB Indications:** Relief of postpartum gas pain - **Contraindications:** Hypersensitivity - **Side Effects:** None significant - **Nursing Considerations:** Administer after meals for best effect - **Client Teaching:** Chew tablets thoroughly if applicable **MMR Vaccine** - **Route(s):** SQ - **OB Indications:** Given postpartum if mother is not immune to rubella - **Contraindications:** Pregnancy, severe immunodeficiency - **Side Effects:** Fever, rash, joint pain - **Nursing Considerations:** Avoid pregnancy for 1 month after administration - **Client Teaching:** Can cause mild flu-like symptoms; discuss future pregnancy plans **Rho(D) Immune Globulin (RhoGAM)** - **Route(s):** IM - **OB Indications:** Prevents Rh sensitization in Rh-negative mothers - **Contraindications:** Rh-positive patients - **Side Effects:** Injection site pain, fever - **Nursing Considerations:** Administer within 72 hours of delivery if baby is Rh-positive - **Client Teaching:** Future doses may be required in subsequent pregnancies **Oxytocin (Pitocin)** - **Route(s):** IV, IM - **OB Indications:** Induction of labor; postpartum hemorrhage control - **Contraindications:** None for postpartum use - **Side Effects:** Uterine hyperstimulation, hypotension - **Nursing Considerations:** Never administer undiluted IV bolus - **Client Teaching:** Expect uterine cramping as a normal response **Misoprostol (Cytotec)** - **Route(s):** Rectal, PO - **OB Indications:** Postpartum hemorrhage management - **Contraindications:** Allergy to prostaglandins - **Side Effects:** Fever, chills, diarrhea - **Nursing Considerations:** Monitor for excessive uterine contractions - **Client Teaching:** Inform of potential flu-like symptoms **Newborn Medications** **Vitamin K (Phytonadione)** - **Route(s):** IM - **OB Indications:** Prevents hemorrhagic disease of the newborn - **Contraindications:** Hypersensitivity to vitamin K - **Side Effects:** Pain at injection site, rare allergic reactions - **Nursing Considerations:** Administer within 1 hour of birth in the vastus lateralis - **Client Teaching:** Essential for newborn clotting; explain importance to parents **Erythromycin Ophthalmic Ointment** - **Route(s):** Ophthalmic - **OB Indications:** Prevents neonatal conjunctivitis from gonorrhea and chlamydia - **Contraindications:** Hypersensitivity to erythromycin - **Side Effects:** Mild eye irritation, blurred vision - **Nursing Considerations:** Apply a thin ribbon in each eye within 1--2 hours of birth - **Client Teaching:** Temporary eye blurriness is normal; do not wipe off immediately **Hepatitis B Vaccine** - **Route(s):** IM - **OB Indications:** Prevents hepatitis B infection - **Contraindications:** Severe allergy to yeast or vaccine components - **Side Effects:** Low-grade fever, injection site redness - **Nursing Considerations:** Requires parental consent; administer in opposite leg from vitamin K - **Client Teaching:** Given at birth, 1--2 months, and 6 months; mild discomfort expected **Hepatitis B Immune Globulin (HBIG)** - **Route(s):** IM - **OB Indications:** Given to infants born to hepatitis B-positive mothers - **Contraindications:** Severe allergic reaction to immune globulin - **Side Effects:** Injection site pain, fatigue - **Nursing Considerations:** Administer within 12 hours of birth; give in opposite leg from vaccine - **Client Teaching:** Provides immediate passive immunity while vaccine builds long-term protection **Naloxone (Narcan)** - **Route(s):** IV, IM, SQ, ET - **OB Indications:** Reverses respiratory depression in newborns due to maternal opioid use - **Contraindications:** Neonates of opioid-dependent mothers (can cause withdrawal) - **Side Effects:** Increased heart rate, nausea, irritability - **Nursing Considerations:** Monitor respiratory status closely - **Client Teaching:** Emergency medication; explain purpose if used **Morphine (for Neonatal Abstinence Syndrome)** - **Route(s):** PO - **OB Indications:** Treats withdrawal symptoms in opioid-exposed newborns - **Contraindications:** Severe respiratory depression, allergy to morphine - **Side Effects:** Drowsiness, constipation, respiratory depression - **Nursing Considerations:** Monitor for signs of oversedation and withdrawal symptoms - **Client Teaching:** Used for controlled weaning; parents should expect drowsiness **Ampicillin** - **Route(s):** IV, IM - **OB Indications:** Prophylaxis for neonatal sepsis, especially in suspected GBS cases - **Contraindications:** Allergy to penicillins - **Side Effects:** Rash, diarrhea, hypersensitivity reactions - **Nursing Considerations:** Monitor for allergic reactions and effectiveness - **Client Teaching:** Part of standard newborn infection prevention **Gentamicin** - **Route(s):** IV, IM - **OB Indications:** Used in conjunction with ampicillin for neonatal sepsis - **Contraindications:** Allergy to aminoglycosides - **Side Effects:** Nephrotoxicity, ototoxicity, dizziness - **Nursing Considerations:** Monitor kidney function and hearing in long-term use - **Client Teaching:** Given only when infection is suspected; explain importance to parents Labor and delivery **Ketorolac (Toradol)** - **Route(s):** IV, IM, PO - **OB Indications:** Short-term management of moderate to severe postpartum pain - **Contraindications:** Hypersensitivity to NSAIDs, active bleeding disorders, renal impairment, postpartum hemorrhage - **Side Effects:** GI bleeding, nausea, dyspepsia, headache, dizziness, renal impairment - **Nursing Considerations:** Monitor for signs of bleeding, assess renal function, avoid use beyond 5 days due to increased risk of renal and GI complications - **Client Teaching:** Take with food to minimize GI upset, report signs of bleeding or persistent pain, avoid concurrent use with other NSAIDs