Tennille Gore
Student Name: Pt Initials: AM
Pt Allergies: PCN
M/B (Post-partum)
Medication List
Drug Dosage/Ro Rationale Side Effects/
(Generic, Trade and ute/ Nursing Implications
Class) Frequency
Methylergonovin 200- Prevention and Dizziness, headache, tinnitus, dyspnea, hypotension,
e 400mcg / treatment of palpitations, nausea, vomiting, cramps, diaphoresis, allergic
PO / Q6-12 postpartum or reactions.
Methergine H / 2-7 post-abortion
Days hemorrhage Monitor blood pressure, heart rate, and uterine response
Classification(s) caused by frequently during medication administration. Notify physician
Therapeutic: oxytocic 200mcg / uterine atony or or other health care professional promptly if uterine relaxation
Pharmacologic: ergot IM / IV / subinvolution. becomes prolonged or if character of vaginal bleeding changes.
alkaloids Q2-4 H / Asses for signs of ergotism (cold, numb fingers and toes, chest
up to 5X pain, nausea, vomiting, headache, muscle pain, weakness).
Pregnancy Category C
Lab Test Considerations: If no response, calcium levels may
IV need to be assessed. Effectiveness of medication is decreased
administrat with hypocalcemia. May cause decrease serum prolactin levels.
ion is used
for
emergencie
s only.
Oxycodone/
Acetaminophen 1-2 Tab / Management of *High Alert*
PO / PRN / moderate to
Endocet, Oxycocet, Q4-6 H severe pain. Confusion, sedation, dysphoria, euphoria, floating feeling,
Percocet, Percocet- hallucinations, headache, unusual dreams, blurred vision,
Demi, Roxicet, Roxilox, diplopia, miosis, respiratory depression, orthostatic
Tylox hypotension, bradycardia, constipation, dry mouth, nausea,
vomiting, urinary retention, flushing, sweating, physical
dependence, psychological dependence, tolerance.
Classification(s)
Therapeutic: opioid
Assess type, location, and intensity of pain prior to and 1 hr
analgesics (in
(peak) after administration. When titrating opioid doses,
combination with
increases of 25-50% should be administered until there is
nonopioid analgesic)
either a 50% reduction in the patient’s pain rating on a
numerical or visual analog scale or the patient reports
Schedule II
satisfactory pain relief. A repeat dose can be safely
administered at the time of the peak if previous dose is
Pregnancy Category C
ineffective and side effects are minimal. Assess blood pressure,
(oxycodone)
pulse, and respirations before and periodically during
administration. If respiratory rate is <10/min, assess level of
sedation. Physical stimulation may be sufficient to prevent
significant hypoventilation. Dose may need to be decreased by
25-50%. Initial drowsiness will diminish with continued use.
Prolonged use may lead to physical and psychological
dependence and tolerance. This should not prevent patient
from receiving adequate analgesia. Most patients who receive
oxycodone for pain do not develop psychological dependence.
Progressively higher doses may be required to relieve pain with
long-term therapy. Assess bowel function routinely. Prevention
of constipation should be instituted with increased intake of
fluids and bulk, and laxatives to minimize constipating effects.
Stimulant laxatives should be administered routinely if opioid
use exceeds 2-3 days, unless contraindicated.
Lab Test Considerations: May increase plasma amylase and
lipase levels.
Toxicity and Overdose: If an opioid antagonist is required to
reverse respiratory depression or coma, naloxone (Narcan) is
the antidote. Dilute the 0.4-mg ampule of naloxone in 10 ml of
0.9% NaCl and administer 0.5 ml (0.02 mg) by direct IV push
every 2 min. For children and patients weighing <40 kg, dilute
0.1 mg of naloxone in 10 ml of 0.9% NaCl for a concentration of
10 mcg/ml and administer 0.5 mcg/kg every 2 min. Titrate
dose to avoid withdrawal, seizures, and severe pain.
Max dose from all sources not to exceed 4000mg per 24 hours
