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23.03 Uterine Stimulants

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Overview

  1. Oxytocin is a naturally occurring hormone that is released during labor and when breastfeeding
  2. Stimulates uterine contractions and increases intensity, strength, and duration of contractions
  3. Synthetic form given as a continuous infusion IV for labor induction or in postpartum hemorrhage

Nursing Points

General

  1. Uses
    1. Induce/augment labor
    2. Help control PPH
    3. Incomplete abortions
  2. Causes extremely painful uterine contractions

Assessment

  1. Monitoring
    1. Frequent monitoring of mom
      1. Contractions
        1. Monitor and chart frequency, duration, intensity
        2. Watch for hypertonic contraction – a single contraction lasting >2 min or >5 contractions in 10 min
      2. Frequent I&O
        1. Side effect is water retention
    2. Frequent fetal monitoring
      1. Continuous fetal monitoring
    3. Assess for uterine atony
      1. Give pitocin to stimulate contractions

Therapeutic Management

  1. Order set – base monitoring, titrations, and interventions based up on this protocol
  2. If the baby has non reassuring fetal heart tones
    1. STOP infusion
    2. Turn mom on left side
    3. O2
    4. Assess baby and mom to see if changes occurred
    5. Notify MD

Nursing Concepts

  1. Pharmacology
  2. Safety

Patient Education

  1. Expect to feel pain/contractions
  2. Purpose of medication
  3. Plan of care
    1. Epidural
    2. Monitoring

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  • Question 1 of 6

A client who had a prolonged labor and was given pitocin during this process should be monitored for what adverse effects? Select all that apply.

  • Question 2 of 6

The nurse is caring for a postpartum client who delivered three hours ago. The nurse assesses the client and notes that she has a boggy uterus. Which of the following is the priority action for the nurse?

  • Question 3 of 6

A client who is 40 weeks pregnant will have labor induced. Which of the following medications does the nurse anticipate giving to this client to initiate this process?

  • Question 4 of 6

Which of the following is a contraindication for the use of oxytocin? Select all that apply.

  • Question 5 of 6

The nurse is caring for a client whose contractions are two minutes apart and the fetus is having late decelerations. Which of the following is an appropriate action for the nurse to take? Select all that apply.

  • Question 6 of 6

The nurse is caring for a client who is experiencing hypotonic labor. What do you expect for her plan of care?

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