Maternity & Newborn Medications: Tocolytics, Analgesics, and Neonatal Pharmacology | Chapter 27 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

Maternity & Newborn Medications: Tocolytics, Analgesics, and Neonatal Pharmacology | Chapter 27 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

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Welcome to Chapter 27 of the Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri. This essential chapter provides a comprehensive overview of key pharmacological agents used in the maternity and newborn period. Understanding these medications—their uses, adverse effects, nursing priorities, and NCLEX-priority actions—empowers nurses to deliver safe, effective care in the perinatal setting.

Watch the complete video summary below, and subscribe to Last Minute Lecture for clinical pharmacology walkthroughs, NCLEX-PN study tips, and high-yield medication safety guidance:

Tocolytics and Labor-Support Medications

  • Magnesium Sulfate: Tocolytic and anticonvulsant used to suppress preterm labor and prevent seizures in preeclampsia. Requires close monitoring for toxicity (respiratory depression, loss of reflexes, low urine output). Calcium gluconate is the antidote.
  • Nifedipine: Calcium channel blocker for preterm labor—watch for hypotension and flushing.
  • Corticosteroids (Betamethasone, Dexamethasone): Administered to mothers at risk for preterm birth to accelerate fetal lung maturity.

Analgesics and Anesthesia for Labor

  • Opioid Analgesics: Fentanyl, meperidine, nalbuphine—relieve pain during labor but may cause neonatal respiratory depression. Naloxone is the reversal agent.
  • Prostaglandins (Misoprostol, Dinoprostone): Used for cervical ripening and labor induction. Contraindicated in certain uterine surgeries or abnormal fetal presentations.
  • Oxytocin: Used to induce labor, augment contractions, and control postpartum hemorrhage. Watch for uterine hyperstimulation—stop infusion and provide intrauterine resuscitation if nonreassuring fetal heart patterns develop.
  • Uterine Stimulants: Methylergonovine, carboprost—used for postpartum hemorrhage; contraindicated in hypertension and asthma, respectively.

Newborn Medications and Nursing Responsibilities

  • Erythromycin Eye Ointment: Prophylaxis against ophthalmia neonatorum from gonorrhea/chlamydia.
  • Phytonadione (Vitamin K): Prevents hemorrhagic disease of the newborn; administered IM soon after birth.
  • Hepatitis B Vaccine: Initiates lifelong immunity; requires parental consent for administration.
  • Lung Surfactants (Beractant, etc.): Given to preterm infants with respiratory distress syndrome to improve lung function.
  • Rho(D) Immune Globulin (RhoGAM): Prevents Rh isoimmunization in Rh-negative mothers after delivery, abortion, or trauma. Not given if mother is already sensitized or infant is Rh-negative.
  • Rubella Vaccine: Given postpartum if mother is non-immune; avoid pregnancy for at least 1 month after administration.

Safety Measures, Antidotes, and NCLEX Tips

  • Monitor for magnesium sulfate toxicity—loss of deep tendon reflexes, respiratory depression, and decreased urine output. Keep calcium gluconate at the bedside.
  • Watch for opioid-induced respiratory depression in newborns; administer naloxone if indicated.
  • Administer oxytocin via infusion pump and closely monitor contraction pattern and fetal heart rate.
  • Be aware of contraindications and adverse effects of uterine stimulants and prostaglandins.
  • Educate parents on the purpose and schedule of newborn vaccinations and prophylactic treatments.

Ready for NCLEX-style medication questions? Watch the video above and subscribe to Last Minute Lecture for more drug calculation guides, pharmacology mastery, and practical exam tips!

Conclusion: Mastering Maternity and Newborn Pharmacology

Chapter 27 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) equips you with the clinical knowledge to administer, monitor, and teach about the most common and high-risk medications used in maternity and newborn care. Understanding mechanisms, side effects, contraindications, and emergency interventions ensures both patient safety and NCLEX-PN exam success.

If you found this breakdown helpful, subscribe to Last Minute Lecture for more chapter-by-chapter medication reviews and high-yield nursing pharmacology guides.

If you found this breakdown helpful, be sure to subscribe to Last Minute Lecture for more chapter-by-chapter textbook summaries and academic study guides.

Explore the full YouTube playlist for Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) here: Complete Playlist

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