Ch. 19 Oxytocin Drug Guide

recommended dose for induction/augmentation

initial: 0.5-6mU/min increase dose by 1-2mU every 15 to 40 minutes *depends on absence of adverse effects and uterine response*

common mixtures that provide 60mU/mL

15 units + 250 mL solution 30 units + 500 mL solution 60 units + 1000 mL solution

oxytocin has which two properties?

vasoactive antidiuretic

effective labor pattern

contractions: frequency Q 2-3 minutes duration 20-90 seconds intensity 50-80 mmHg (IUPC)

indication

-maintenance of uterine contraction after birth -induction or augmentation -management of inevitable or incomplete abortion

action

-similar to natural hormone -stimulates uterine smooth muscle: increased strength, duration, frequency of uterine contractions

if tachysystole or non reassuring FHR pattern occurs, what must the nurse do?

1. stop infusion 2. increase rate of nonadditive solution 3. position woman laterally 4. admin oxygen 8-10L/min 5. notify physician of adr, nursing intervention, patient response

dose for inevitable/incomplete abortion

dilute 10 units in 500mL infuse 10-20mU/min

dose to control postpartum bleeding

dilute 10-40 units in 1000mL of IV solution IV: begin rate at 20-40mU/min IM: inject 10 units after delivery of placenta

uterine hypertonicity may result in which FHR patterns?

fetal bradycardia tachycardia reduced FHR variability late decelerations

adr

hypertonic uterine activity fetal asphyxia from impaired uterine blood flow uterine rupture abruptio placentae fetal or maternal trauma from rapid birth maternal fluid retention leading to water intoxication hypotension tachycardia cardiac dysrhythmias subarachnoid hemorrhage

contraindications of oxytocin

placenta previa vasa previa nonreassuring FHR abnormal fetal presentation prolapsed umbilical cord presenting part above pelvic inlet previous classic or other fundal uterine incision active genital herpes infection pelvic structural deformities invasive cervical carcinoma

with each dosage increase, the nurse must record

pulse bp RR intake/output *usually every 30-60min*