M2 QUIZ

• Folic Acid


  To prevent spontaneous abortion and neural tube defects, recommended to be given 1 month before conception and for the 1st 2-3 months after conception @ 0.4mg-0.8mg
• Common side effects of taking iron preparations

  • Nausea & vomiting
  • Constipation
  • Black, tarry stools
  • GI irritations
  • Epigastric pain
  • Discoloration of urine
  • Diarrhea
• Recommended iron demand during pregnancy

  • 1st trimester: 6.4mg/day
  • 2nd trimester: 18.8mg/day
  • 3rd trimester: 22.4mg/day
• Iron supplement goal


  • Prevent maternal iron deficiency anemia and not to supply the fetus with iron
• Prenatal Vitamin preparations

  • Vitamin A
  • B complex
  • B12
  • Vitamin C
  • Calcium
  • Vitamin D
  • Vitamin E
  • Iron
• Iron


  Fetal and maternal daily requirement for iron is 27mg/day during pregnancy
• If pregnant patients have decreased hematocrit early in 3rd trimester with below 30%


  The iron dosage must be increased
• Folate rich foods


  • Green leafy vegetables, asparagus, papaya, strawberries, oranges
• Adverse reactions to Folic Acid

  • Rash
  • Allergic bronchospasm
  • Pruritus
  • Erythema
  • Malaise
  • Urine may turn intensely yellow
• Nursing considerations for iron

  1. Dilute iron with water and use straw in giving liquid iron to prevent staining of teeth

  2. Iron is best absorbed with juice and on an empty stomach

  3. Vitamin C increases iron absorption

  4. If there would be gastric irritation, administer iron with food

  5. Don’t administer iron with milk, cereal, tea, coffee, or eggs

  6. Don’t mix antacid with iron, give iron 2 hours before or 4 hours after antacid
• Mechanism of Action for morning sickness treatment

  Competes with histamine for h2 receptor sites
• The FDA approves pyridoxine hydrochloride & doxylamine succinate for treatment of morning sickness
• Antacids for heartburn in pregnancy

  First line of therapy, neutralizes gastric acidity
• Causes of constipation may be related to hormonal changes specifically progesterone which decreases gastric motility
• Dosage for Acetaminophen: 325mg or 500mg every 3-4 hours but not to exceed 8 tabs in 24 hours
• Prenatal Vitamin preparations contain

  • Vitamin A
  • B complex
  • B12
  • Vitamin C
  • Calcium
  • Vitamin D
  • Vitamin E
  • Iron
• Over the counter antacids commonly used in pregnancy

  • Aluminum hydrochloride
  • Magnesium hydrochloride
• Rate of absorption of Acetaminophen is dependent on the rate of gastric emptying
• Docusate sodium is the 1st line of treatment for constipation during pregnancy
• 88% of patients' complaints for morning sickness
• Long term use of antacids is discouraged to prevent fetal problems
• Acetaminophen is the most common non-prescription drug during pregnancy and can be used during all trimesters
• PORACTANT

  • Route & Dosage: 2.5 mL/kg per dose divided in 2 equal amounts, administer each half amount to each main bronchus
  • Porcine-derived surfactant for prophylactic and treatment of RDS in premature infants
• Exogenous surfactant therapy for prevention & treatment of RDS

  • BERACTANT
  • CALFACTANT
  • PORACTANT
• Drugs administered to preterm neonates

  • SYNTHETIC SURFACTANT
• ERYTHROMYCIN OPHTHALMIC OINTMENT is the common anti-infective administered to a newborn’s eyes. It is given as a prophylactic treatment against eye infections
• Drug administered to full-term healthy neonates: ERYTHROMYCIN OPHTHALMIC OINTMENT
• BERACTANT

  • Route & Dosage: 4mL/kg per dose divided into 4 equal amounts
  • Uses & Considerations: Bovine-derived surfactant for prophylactic and treatment of RDS in premature infants
  • Must be given by healthcare personnel experienced with using ventilators for prevention or rescue in treatment of RDS
  • Administered through Fr.5 catheter inserted into an ET tube
• When preterms are born they still possess an immature lung development and breathing control, decrease airway muscle tone and surfactant level, thus the neonate may suffer from RDS (Respiratory Distress Syndrome)
• CALFACTANT

  • Route & Dosage: 3mL/kg per dose divided in 2 equal amounts
  • Calf-derived surfactant for prophylactic and treatment of RDS in premature infants
• Side effects of ERYTHROMYCIN OPHTHALMIC OINTMENT include chemical conjunctivitis
• Nursing interventions for synthetic surfactant

  • Maintain a patent airway
  • Monitor infant’s VS before, during, and after surfactant therapy
  • Maintain adequate respiratory status
  • Monitor ABG’s and obtain a chest radiography study
  • Don’t perform ET suction immediately after administration of surfactant unless signs of airway obstruction are present
  • Position and reposition the infant as needed for equal distribution of surfactant throughout the lungs
  • Support and educate parents
• ERYTHROMYCIN OPHTHALMIC OINTMENT


  • Administered within 1 hour after delivery by placing 1cm of the drug without touching the tip of the ointment in the newborn’s eyes
  • Used for prevention of ophthalmic neonatorum & protection against gonococcal and chlamydial conjunctivitis
• PHYTONADIONE
• ERYTHROMYCIN OPHTHALMIC OINTMENT


  • Common anti-infective administered to a newborn’s eyes
  • Given as a prophylactic treatment against eye infections
  • Side effects include chemical conjunctivitis that would manifest as eye edema and inflammation lasting about 24-48 hours
  • Used in Crede’s Prophylaxis
• HEPATITIS B INJECTION
• ERYTHROMYCIN OPHTHALMIC OINTMENT
• HEPATITIS B INJECTION


  • Administered 0.5mL IM within 12 hours after birth in the vastus lateralis of the newborn
  • Protects the newborn from Hepatitis B
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  January 17, 2021
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  January 17, 2021