Labor and Delivery

Question 1

Uterine Stimulants: Oxytocics
medications
expected action

Answer 1

• oxytocin is a peptide hormone produced by the posterior pituitary gland
  1) prototype = oxytocin (Pitocin, Syntocinon)
  2) other medications = methylergonovine (Methergine)
  3) increase the force, frequency, and duration of uterine contractions

Question 2

Oxytocin:

therapeutic uses

Answer 2

1) induction of labor
2) enhancement of labor
3) delivery of the placenta
4) control of postpartum bleeding
5) fetal stress testing
6) milk ejection (intranasal)

Question 3

Methergine:

therapeutic uses

Answer 3

1) serious postpartum hemorrhage
2) augmentation of labor
3) migraine headaches

Question 4

Oxytocin:
side/adverse effects
nursing interventions/client education

Answer 4

1) uterine rupture
2) -monitor for strength, frequency, and duration of contractions
- have magnesium sulfate on standby if needed for relaxation of the uterus

Question 5

Methylergonovine (Methergine):
side/adverse effects
nursing interventions/client education

Answer 5

1) hypertensive crisis
2) monitor for:
- headache
- nausea
- vomiting
- increased BP

Question 6

Methylergonovine (Methergine):

nursing administration

Answer 6

1) administer IV using a pump
2) the flow rate is down by parameters and adjusted by an increase of 1 mcg/min every 30 min
3) monitor uterine contractions closely. contractions should last about 1 min and occur every 2-3 min
4) continuously monitor the mother’s BP and HR
5) continuously monitor the fetal HR
6) if hyperstimulation occurs, stop the infusion and notify the provider immediately

Question 7

Tocolytic Medications:
expected action
therapeutic uses

Answer 7

• prototype = terbutaline sulfate (Brethine)
  1) results in uterine smooth muscle relaxation
  2) delays preterm labor

Question 8

Tocolytic Medications:

side/adverse effects

Answer 8

1) tachycardia
2) palpitations
3) chest pain
4) tremors, anxiety, headache