Page 863 - Saunders Comprehensive Review For NCLEX-RN

2. Monitor mother for signs of infection.
3. Monitor white blood cell count.
4. Monitor blood glucose levels.
5. Administer by deep intramuscular injection.
IV. Opioid Analgesics
A. Description
1. Used to relieve moderate to severe pain associated
with labor
2. Administered by intramuscular or IV route

3. Regular use of opioids during pregnancy may

produce withdrawal symptoms in the newborn
(irritability, excessive crying, tremors, hyperactive
reflexes, fever, vomiting, diarrhea, yawning, sneezing,
and seizures).

4. Antidotes for opioids

a. Naloxone is usually the treatment of
choice because it rapidly reverses
opioid toxicity; the dose may need to
be repeated every few hours until
opioid concentrations have decreased
to nontoxic levels.
b. These medications can cause
withdrawal in opioid-dependent
clients.
B. Hydromorphone hydrochloride
1. Can cause dizziness, nausea, vomiting, sedation,
decreased blood pressure, decreased respirations,
diaphoresis, flushed face, and urinary retention
2. May be prescribed to be administered with an
antiemetic such as promethazine to prevent nausea
3. High dosages may result in respiratory depression,
skeletal muscle flaccidity, cold clammy skin, cyanosis,
and extreme somnolence progressing to seizures,
stupor, and coma.
4. Used cautiously in clients delivering preterm
newborns
5. Not administered in advanced labor (typically once
transition phase during stage 1 of labor has been
reached); if the medication is not adequately removed
from the fetal circulation, respiratory depression can
occur.
C. Fentanyl and sufentanil can cause respiratory depression,
dizziness, drowsiness, hypotension, urinary retention, and fetal
narcosis and distress; sufentanil is used less commonly than
fentanyl.

863