Dena Evans, EdD(c), MPH, BSN, RN, CNE Assistant Professor Department of Nursing The 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

 Rh o 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 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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