Dena Evans, EdD(c), MPH, BSN, RN, CNE Assistant Professor Department of Nursing The University of North Carolina at Pembroke.

Dena Evans, EdD(c), MPH, BSN, RN, CNEAssistant Professor

Department of NursingThe University of North Carolina at Pembroke

See Routine Orders pg. 857

Prevent uterine atony Relive pain Enhance or suppress lactation Promote bowel function Enhance immunity

NSAIDS• May prolong bleeding time• Take with food or water ↓ GI upset

Narcotics

Systemic analgesics• Decreased alertness

Opioids• Bowel function• Respirations

Redness Ecchymosis Edema Discharge Approximation

Witch hazel Nupercainal onitment Nonpharmacological

• Sitz baths

Medications not used/less popular due to side effects• Chlorotrianisene (Tace)• Deladumone OB• Bromocriptine mesylate (Parlodel)

You may be asked about these by a family member

Now-support bras, breast bindings, axillary ice packs

Flatus• Antiflatulants• Ambulation• Increase water intake• High-fiber foods

Colace Peri-Colace Dulcolax MOM Mineral Oil Nursing Process Laxatives-pg. 864

Rho D Immune Globulin Explain erythroblastosis fetalis Direct vs. Indirect Coomb’s test

Given prenatally in approx. 1-2% of Rh- women.

Assessed at initial prenatal visit and again at 28-29 weeks.

Can be given IM within 72 hours after delivery

Routinely given after maternal/fetal blood mixing.

Human D immunoglobulin Religious Beliefs**

AKA German Measles High rate of abortion, neurological

defects Congenital rubella syndrome First Trimester-risk After First Trimester-less risk Vaccine is contraindicated during

pregnancy

Burning at injection site acidic pH of vaccine.

Urticaria-allergic reaction Malaise Fever Headache Arthralgia Moderate fever

Hypotension Chills Dizziness Headache Pruritis Injection site reaction Have epinephrine available to treat

anaphylaxis

Erythromycin Ophthalmic Ointment Vitamin K Anti-infective agents (cord stump)

• Literature supports drug cord care

EES-chemical conjunctivitis Vitamin K-prevents bleeding

• Pain and edema at injection site• Allergic reaction• Hyperbilirubinemia and jaundice

Bilirubin and Vitamin K = protein binding sites

HBV Require maternal consent (signed) Number based on mothers HBsAg

status IM-vastus lateralis (preferred site) or

rectus femoris Negative-only one injection Positive-two

• HBV vaccine AND HBIG (hepatitis B immune globulin)

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