Author Question: A patient who is having her sixth child has gone beyond term, and her labor is being induced with ... (Read 78 times)

123654777 · **on:** Jul 23, 2018

A patient who is having her sixth child has gone beyond term, and her labor is being induced with oxytocin (Pitocin). The patient is having increased frequency, duration, and intensity of contractions.

The nurse will interrupt the oxytocin infusion if what occurs?
a. Contractions occur every 2 to 3 minutes.
b. Individual contractions last 2 minutes.
c. Mild to moderate pain occurs with uterine contractions.
d. Resting intrauterine pressure is greater than 10 to 15 mm Hg.

Question 2

A pregnant patient is being induced with oxytocin, which has been infusing for 1 hour. The initial rate was 6 milliunits/min, and the rate now is 18 milliunits/min.

The nurse notes regular contractions occurring every 3 minutes, each lasting 35 seconds. The nurse will:
a. increase the rate of infusion by 1 to 2 milliunits/min every 15 to 40 minutes.
b. increase the rate of infusion by 3 to 6 milliunits/min every 15 to 40 minutes.
c. interrupt the infusion and continue to monitor the patient before restarting.
d. interrupt the infusion and notify the provider of potential oxytocin toxicity.

vish98 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
Induction of labor in patients of high parity (five or more pregnancies) carries a high risk of uterine rupture, and oxytocin should be used with great caution. Oxytocin infusions should be interrupted for contractions that last longer than 1 minute. Contractions that occur more often than every 2 to 3 minutes are a concern. Mild to moderate pain is normal with contractions. A resting intrauterine pressure greater than 15 to 20 mm Hg is a concern.

Answer to Question 2

ANS: B
This patient is being induced with a high-dose regimen of oxytocin, which starts at 6 milliunits/min and is increased by 3 to 6 milliunits/min every 15 to 40 minutes. The frequency and rate of her contractions are within normal limits, so the nurse can continue to increase the rate by 3 to 6 milliunits/min every 15 to 40 minutes until contractions last longer than 1 minute or occur more frequently than every 2 to 3 minutes. Increasing the rate of infusion by 1 to 2 milliunits/min every 15 to 40 minutes is part of the low-dose regimen. Because the frequency and duration of contractions have not reached optimum level, there is no need to interrupt the infusion. There are no signs of oxytocin toxicity.