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Our doctors order either Stadol 1-2 mg every 2 hours, IVP or Nubain, 5-10mg every 3. We do not mix stadol with any other drug. If we are trying to achieve therapeutic rest (patient not yet actively laboring yet)----we will usually give Morphine 10mg or Nubain 15 mg WITH either Vistaril 25 mg IM or Phenergan, 25 mg IM. This allows the lady to rest and either go into active labor, or go home and sleep after a couple hours' observation.
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Most of our MD's order stadol 1-2mg q 3-4, which in my opinion is not nearly often enough... I find that it seems to wear off after about an hour. As bad as it sounds, sometimes I really wonder if a couple of the MD's do it to push the moms into just getting an epidural (b/c there's really no other pain relief option on our unit if their 3-4 hours aren't up).
We have only one MD who has it for hourly.
Sometimes we do give it with phenergan 25mg (that is usually q6) & they potentiate each other.
We pretty much never do the 'therapeutic rest' thing that SBE mentioned above, but sometimes I wish we did.
Once in a blue moon we have a certain anesthesia MD who will ask us to give Nubain if he's delayed in getting to us to do an epidural.
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1,907 Posts
Therapeutic rest is a LIFE SAVER for patients, doctors, and nurses alike. I love it! So do our patients.
Yeah, I'm not sure what the deal is with our MD's not doing it. We have a lot of girls that we send home in early labor & come back already tired and 'behind the power curve' going into active labor. Maybe I'll ask a couple of the MD's... :)
20,964 Posts
Therapeutic rest is employed when we give people in prodromal labor a cocktail of pain meds and medication to help them sleep. We do this for people who are contracting and uncomfortable, but are not making any progress, yet. It generally will do one of two things: either let them rest and wake up in active labor, ready to go or allows them to rest when they do get discharged home.
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Race Mom, ASN, RN
808 Posts
Our typical order is 1mg per hour PRN. Some docs choose 1-2 mg per hour PRN.