Oxytocin (Maternal-Newborn)

A multipara at 38 weeks' gestation arrives at the labor and delivery unit in active labor. The nurse performs a sterile vaginal examination and determines that the patient's cervix is dilated to 8 cm. The patient has no IV access at the time of delivery. The nurse recognizes that the patient has an increased risk of postpartum hemorrhage because of multiparity. Which dose of oxytocin is most commonly prescribed to be administered intramuscularly after delivery of the placenta to prevent postpartum hemorrhage? A. 10 milliunits of oxytocin B. 20 milliunits of oxytocin C. 10 units of oxytocin D. 20 units of oxytocin

C. 10 units of oxytocin

The nurse is admitting a patient at 40 weeks' gestation for induction of labor. The nurse knows that in most cases, contraindications for labor induction are the same as the contraindications for vaginal birth. What contraindication would the nurse need to report to the practitioner? A. Group Beta Streptococcus positive B. Vertex presentation C. Active genital herpes D. Previous cesarean delivery with low transverse uterine incision

C. Active genital herpes

A patient at 38 weeks' gestation with a history of preeclampsia is being induced. The patient received a dose of misoprostol 3 hours ago. The practitioner places an order for the nurse to start IV oxytocin now. What is the nurse's response? A. Start the oxytocin as soon as the pharmacy sends the premixed bag. B. Mix the oxytocin bag on the unit so there is no delay in initiating the oxytocin. C. Notify the practitioner of when the dose of misoprostol was given. D. Wait 2 hours to start the oxytocin.

C. Notify the practitioner of when the dose of misoprostol was given.

The nurse has received an order from the practitioner to begin labor augmentation with IV oxytocin on a patient at 39 weeks' gestation. The pharmacy notifies the nurse that no premixed bags are available and that the premixed solution will arrive on the unit in approximately 30 minutes. What is the most appropriate nursing action? A. Alert the practitioner that the oxytocin infusion is being held until the pharmacy delivers the solution to the unit. B. Obtain a vial of oxytocin and an isotonic solution and mix the oxytocin solution on the unit so the infusion can begin on time. C. Administer a dose of oxytocin 10 units IM in the left thigh to initiate the induction until the premixed solution is available. D. When the premixed oxytocin solution arrives from the pharmacy, give a bolus of it to initiate the induction.

A. Alert the practitioner that the oxytocin infusion is being held until the pharmacy delivers the solution to the unit.

When administering oxytocin for induction of labor with a low-dose or high-dose administration protocol, what is the usual frequency for incremental increases? A. Every 15 to 40 minutes B. Every 15 to 60 minutes C. Every 10 to 45 minutes D. Every 10 to 40 minutes

A. Every 15 to 40 minutes

A patient has been given oxytocin at 5 milliunits/min for the past hour to augment labor. The patient's contractions are occurring every 1 to 3 minutes. The student nurse asks whether tachysystole is present. What should the nurse offer as the definition of tachysystole? A. More than 5 contractions in 10 minutes averaged over a 30-minute window B. Fewer than 6 contractions in 10 minutes averaged over a 30-minute window C. Contractions every 1 to 3 minutes D. Contractions lasting longer than 2 minutes

A. More than 5 contractions in 10 minutes averaged over a 30-minute window

The nurse removed the dinoprostone an hour ago from the cervix of a patient being induced for gestational diabetes at 39 weeks' gestation. The patient is having strong contractions lasting 60 to 90 seconds every 3 minutes. The nurse is preparing to start administration of oxytocin. What possible complication could occur? A. Rupture of membranes B. Tachysystole C. Increased pain D. Fetal bradycardia

B. Tachysystole

A patient is receiving oxytocin for induction of labor with an initial infusion rate of 2 milliunits/min and a titration rate of 2 milliunits/min every 30 minutes. The FHR tracing indicates a Category I pattern with uterine tachysystole. Despite implementation of interventions that include repositioning the patient to a lateral position and administering an IV fluid bolus, the tachysystole continues. A Category II FHR tracing is then observed. The nurse discontinues the oxytocin, which was infusing at 12 milliunits/min. After the infusion has been discontinued for 20 minutes, the tachysystole has resolved and the fetal monitor tracing indicates adequate fetal oxygenation. At which rate should the nurse restart the oxytocin infusion? A. 12 milliunits/min B. 6 milliunits/min C. 2 milliunits/min D. 1 milliunit/min

B. 6 milliunits/min

A nurse is caring for a patient who has been receiving an oxytocin infusion for labor induction. The infusion was initiated approximately 8 hours ago and is currently infusing at 20 milliunits/min. While assessing the patient, the nurse observes a Category I FHR tracing with a contraction pattern of six contractions in 10 minutes averaged over 30 minutes. Which of these nursing interventions should come first? A. Further evaluate the fetal tracing. B. Decrease the oxytocin infusion. C. Place the patient in a lateral position. D. Administer oxygen at 10 L/min via nonrebreather mask.

C. Place the patient in a lateral position.

The nurse admits a patient to the labor and delivery unit for induction of labor. The patient is at 37 weeks' gestation and has preeclampsia. The last ultrasound showed fetal growth restriction. The patient's current vital signs are blood pressure 167/101 mm Hg, pulse 96 beats per minute, respirations 20 breaths per minute, and temperature 36.4°C (97.5°F). The patient denies feeling contractions or having pain. The practitioner has written orders to begin labor induction with oxytocin. What should the nurse do to establish maternal and fetal well-being upon admission? A. Obtain a specimen for a basic metabolic panel to determine the patient's electrolyte levels. B. Ask the practitioner to order tests to determine fetal lung maturity. C. Ask the practitioner to provide a valid reason for the induction of labor. D. Monitor the FHR and contraction patterns electronically for 20 to 30 minutes.

D. Monitor the FHR and contraction patterns electronically for 20 to 30 minutes.