A client who is receiving oxytocin (Pitocin) infusion for the ...

[berenicecastro]

A client who is receiving oxytocin (Pitocin) infusion for the augmentation of labor is experiencing a contraction pattern of more than eight contractions in a 10-minute period. Which intervention would be a priority?
 
  a. Increase rate of Pitocin infusion to help spread out contraction pattern.
  b. Place oxygen on client at 8 to 10 L/min via face mask and turn client to left side.
  c. Stop Pitocin infusion.
  d. Call physician to obtain an order for initiation of magnesium sulfate.

Question 2

A vaginal exam for a laboring multipara client who is 42 weeks' gestation reveals the following information: 4 cm, minimal effacement, -2 station.
 
  Which clinical factors would affect the clinical management decision not to rupture membranes with an AmniHook?
 
  a. Vaginal dilation
  b. Client is a multipara
  c. Presenting part is at 2 station
  d. Gestational age

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Answer to Question 1

ANS: C
The client is exhibiting uterine tachysystole (uterine tetany). Priority intervention is to stop the infusion. The next course of action is to place oxygen on the client and reposition and increase the flow rate of the primary infusion. If the condition does not improve, the physician may be called for additional orders.

Answer to Question 2

ANS: C
The fact that the presenting part is not engaged causes concern because there is increased risk of a prolapsed cord on artificial rupture of membranes (AROM). Vaginal dilation is adequate for attempt to rupture membranes. The fact that a client is a multipara is not a significant reason to affect clinical decision making with regard to AROM. Postdates of pregnancy may warrant a more aggressive approach to speed the labor and birth process.