Question

Describe the effects of the following medications on the fetus/newborn:

1. Opioids:

2. Magnesium Sulfate:

3. Epidural medications:

4. Spinal medications:

What nursing interventions will you perform to prevent or correct these effects on the fetus for each of the following medications?

1.Opioids

2.Magnesium Sulfate

3.Epidural medications

4.Spinal medications

Answer 1

1)Opioids:

a Used to relieve moderate to severe pain associated with labor.

b.Regular use of opioids during pregnancy may produce withdrawal symptoms in the newborn such as irritability,excessive crying,temors,hyperactive reflexes,fever vomiting,diarrhea,yawning and seizures.

Interventions: 1. Monitor the respiratory status.

2.Monitor the fetal heart rate and characteristics of uterine contractions

3.Monitor for blood pressure changes

2) Magnesium sulphate:

a. It is a central nervous depressent and anticonvulsant.

b.The medication can cause smooth muscle relaxation.

c .Stopping preterm labor to prevent preterm birth.

d.Preventing and controlling seizures.

Adverse effects are:Respiratory depression,depresse reflexes,flushing,hypotension.Continous intravenous infusion increases the risk of magnesium toxicity in the newborn.High doses can cause loss of deep tendon reflexes,heart block and respiratory paralysis.

Interventions:

1.Monitor vital signs.

2 Assess renal function and echocardiogram for cardiac function.

3 Monitor deep tendon reflexes hourly for signs of toxcity.

4 Test the patellar reflex or knee jerk reflex before administrating a repeat parenteral dose.

5 Monitor intake and output hourly.

3)Epidural medications: The pain relief from a epidural is obtained by blocking the conducion of impulses along the sensory nerves as they enter the spinal cord.

The effects of epidural medications in fetus or newborn includes,Respiratory depression,vomiting,aspiration, fever, hypotension and so on

Interventions:Monitor fetal status.

Assess maternal blood pressure and assess bladder frequently.

Monitor for any complications

4)Spinal medications: Injection of the anaesthetic agent into the suaraconid space of spinal cord.

Adverse effcets of medications causes hypotension,decrease heart rate,dizziness,drowsiness,distress and so on

Interventions:1.Monitor vital signs

2 Monitor fetal heart rate

3Administered intravenous fluids as prescribed.