Medicine Management

 

  1. Name and describe the different drugs administered for induction of labour

Prostin (vaginal tablets)

Propess- (pessary)         

  1. Discuss with your mentor how these different drugs are administered and what dosages are used and why.

Prostin: 3 mg, inserted high into the posterior  fornix, followed by 3 mg after 6–8 hours, to be given if labour not established; maximum 6 mg per course.

Propess: is a pessary, 10mg is inserted into the posterior fornix of the cervix. The pessary contains the drug dinoprostone, which has the same effect as the naturally occurring hormone prostaglandin (which is involved in starting labour). Dinoprostone stimulates the muscles in the cervix, causing the cervix to dilate. This in turn stimulates the muscles in your uterus causing them to start contracting and labour to begin.

 

  1. Discuss the side effects of these drugs.

 

Epidural and spinal analgesia

 

  1. Compare the advantages and disadvantages of using epidural analgesia in labour

 

  1. Describe the differences between epidural and spinal analgesia.

 

  1. Describe how an epidural is sited, topped – up and the epidural cannula removed.

 

  1. Provide examples of drugs used in epidural analgesia and discuss their side effects.

 

 

Active management of the third stage of labour

 

  1. What drugs are used in active management of the third stage of labour?

 

  1. What are the side effects and contraindications of using these drugs?

 

  1. Name all the drugs which may be administered during a postpartum haemorrhage.

 

  1. What are the side effects and contra-indications of the drugs used in the management of PPH?

 

  1. Discuss with your mentor the drug dosages and methods of administration

Intravenous fluids

  1. Discuss the reasons why IV fluids may be administered?
  2. What are the differences between crystalloids and colloids?
  3. List the drugs that are kept on the cardiac arrest trolley in your unit.

 

  1. Discuss examples of the dosages and methods of administration.

 

Epilepsy

  1. Name the Drugs/Medication prescribed by a Doctor that you may administer to an epileptic woman.
  2. Describe how you would administer these drugs.
  3. Explore the chemical interactions of certain drugs given to treat epilepsy and what, if any, cautions should be considered when administering them.

 

  1. Discuss the possible side effects of these drugs.

 

Diabetes

  1. Discuss the different hypoglycaemics used in the management of type 1 and type 2 diabetes.
  2. What are the contraindications and side effects of these drugs?
  3. What other drugs/medicines interact with these drugs?

Antibiotics

  1. Discuss the reasons for using antibiotics in the antenatal, intranatal and postnatal period.
  2. List the common antibiotics used during the pregnancy continuum, dosages, side effects and contraindications.
  3. Discuss the use of antibiotics and breastfeeding.

Thyroxine

  1. Discuss the use of thyroxine in managing hypothyroidism during the pregnancy continuum.

Antidepressants

  1. What are antidepressants and how do they work?
  2. List the different drugs used to treat postnatal depression, dosages, side effects and contraindications.
  3. What other drugs can interact with these medications?
  4. Which drugs are used in the antenatal period to treat depression and what are the risks to the fetus?

 

Neonatal

Vitamin K (Phytomennadione)

  1. Discuss the reasons vitamin K is offered to all neonates.
  2. Describe the methods of administration, dosage, side effects and contraindications.
  3. What drug is commonly administered to women to promote fetal lung surfactant production prior to 36 weeks gestation?
  4. What is the dose given, route of administration, side effects and contraindications of this drug?
  5. List any medication you have seen given to neonates during your second year with a brief description of each.

Activity 1- Thyroid Disorders

Thyroid disease is one of the most common endocrine diseases likely to occur in women of child-bearing age.

1) Outline the anatomy and physiology of the thyroid gland.

2) Discuss the similarities between the clinical symptoms of thyroid disease and pregnancy.

3) What is the most common cause of hypothyroidism in pregnancy?

4) What are the symptoms of hypothyroidism and how should this be managed in pregnancy?

5) Discuss thyroid disease in relation to your Trust guidelines on management and care of the pregnant woman with hypothyroidism.

6) Discuss the differences between hypo/ hyperthyroidism.

Word count:  (Max 2000)

This section is for you to build on your knowledge and skills around maternal medical conditions and complications.

 

Activity 2 – Cardiac Disease

1) Revise the physiological changes in the cardiac system in pregnancy, give brief bullet points below.

2) List the different types of cardiac conditions a woman may present with.

3) Discuss the care and management of women with cardiac disease during intrapartum care.

Word count:  (Max 2000)

Maternal Complications- Antenatal

List any maternal complications in the antenatal period you encounter this year with a brief description of each

 

Maternal Complications- Intrapartum

List any maternal complications you encounter/experience during your labour ward placement (excluding obstetric emergencies). Give a brief description of each.

 

Maternal Complications- Postnatal

List any maternal complications you encounter/experience during the postnatal period with a brief description of each.

 

Fetal Medical Conditions and Complications

List any fetal medical conditions and/or complications that you encounter this year and give brief descriptions of each.

 

Neonatal Medical Conditions and Complications

List any neonatal conditions and/or complications that you encounter this year and give brief descriptions of each

This section is to help you build on your knowledge and skills in relation to fetal and neonatal complications.

Activity 1- Congenital Defects

Congenital defects. Give a brief definition of the following congenital defects and an overview of management and care (refer to your Trust guidelines and other appropriate stakeholder guidance). such as NICE

1) Two vessels in umbilical cord.

2) Hypospadias

3) Fetal alcohol syndrome.

4) Cleft lip and palate

5) Tracheal Oesophageal Fistula

6) Talipes

Activity 2 – Thermal Care/ Hypothermia

1) Discuss the physiology of thermal regulation in the newborn.

2) List the effects of cold stress on the newborn.

3) Discuss the care and management of a newborn with hypothermia.

 

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