When a laboring client receiving 12 mU of pitocin for induction ...

[Alainaaa8]

When a laboring client receiving 12 mU of pitocin for induction develops a contraction pattern of every 2 minutes lasting 80 seconds and recurring late decelerations, the nurse should immediately:
 
  a. stop oxytocin infusion.
  b. administer O2 at 8 TO 10 L/min.
  c. reposition client to left side-lying position.
  d. increase the rate of the primary nonadditive infusion.

Question 2

Select the situation that describes the safest administration of oxytocin induction and cervical ripening agents.
 
  a. Concurrent use of oxytocin and dinoprostone (Cervidil)
  b. Misoprostol (Cytotec) 25 mcg, followed in 4 hours by oxytocin induction in vaginal birth after cesarean section (VBAC) client
  c. Dinoprostone (Cervidil) 10 mg in place for 12 hours followed by oxytocin induction in 1 hour
  d. Maximum dose of dinoprostone (Prepidil) 2 mg/24 hr followed in 4 hours by oxytocin induction

[ttt030911]

Answer to Question 1

ANS: A
Uterine hyperstimulation can reduce placental blood flow and decrease fetal oxygenation. Late decelerations are caused by uteroplacental insufficiency. Stopping the oxytocin infusion will reduce uterine activity and increase fetal oxygenation. Administering O2, repositioning the client, and increasing the rate of the primary nonadditive infusion will not be effective until hyperstimulation is resolved.

Answer to Question 2

ANS: C
Dinoprostone (Cervidil) in a 10-mg, time-release insert may be left in place for up to 12 hours and oxytocin induction can be safely started 1 hour after insert is removed. Oxytocin and cervical ripening agents cannot be administered at the same time. Misoprostol (Cytotec) is contraindicated in a women with previous cesarean. The maximum dose of dinoprostone (Prepidil) 1.5 mg/24 hr.

[Alainaaa8]

Thank you

[ttt030911]

Happy to help you