Pain Management

Types: Butorphanol (Stadol) and nalbuphine hydrochloride (Nubain)

Definition: Narcotics are used to control pain during labor. Can be administered IV or IM. The antidote for narcotics is naloxone (Narcan).

Side Effects: GI upset, drowsiness, hypotension, urinary retention, respiratory depression, and vision disturbances.

Nursing Care: Monitor vital signs and fetal heart tones before administration. Monitor urine output. Monitor for side effects and complications. Narcan should be available for emergency use.

Prostaglandins

Types: Dinoprostone (Cervidil and Prepidil).

Definition: They are used to stimulate labor and increase uterine contractions. Prostaglandins are administered vaginally.

Side Effects: GI upset, headache, hypotension, rapid labor, and fever.

Nursing Care: Monitor maternal vital signs, contractions, and fetal heart tones. Administer medication vaginally, and have the patient lie on her side for 30 minutes. Prepare the mother and family for delivery. Administer medications for pain as prescribed. Monitor for side effects and complications.

Rho (D) Immune Globulin (RhoGAM)

Definition: RhoGAM is administered to Rh-negative patients who may have been exposed to the Rh-positive antibody. RhoGAM is given intramuscularly.

Side Effects: Swelling and pain at the injection site. Do not administer medication to Rh-positive women.

Nursing Care: If the patient has been exposed to Rh-positive blood, then RhoGAM is administered twice during pregnancy. If the infant is exposed to Rh positive, RhoGAM is administered within 72 hours.