ob chapter 23 part 1- induction to uterine hyperstimulation Flashcards
What is the most common method used to promote cervical ripening?
Insertion of a prostaglandin (Prepidil, Cervidil) into the posterior fornix of the vagina, by the cervix.
What drug is often used off-label to assist in cervical ripening?
Misoprostol.
What precautions are necessary when using prostaglandins or misoprostol for cervical ripening?
Fetal heart rate (FHR) and vital sign assessments.
When is oxytocin used for labor induction?
After the cervix is “ripe,” oxytocin is administered to initiate labor contractions.
What is oxytocin?
A synthetic form of a naturally occurring pituitary hormone used to initiate labor contractions.
What are the side effects of oxytocin related to peripheral vessel dilatation?
Peripheral vessel dilatation can lead to extreme hypotension. Monitor HR & BP every hour.
What are the side effects of oxytocin related to urine flow?
Decreased urine flow can lead to water intoxication, first manifested by headache and vomiting. Report immediately and stop the infusion.
What are the severe complications of water intoxication due to oxytocin?
Seizures, coma, and death. Monitor intake and output (I&O).
How is oxytocin commonly mixed for IV infusion?
10 IU in 1,000 mL of Lactated Ringer’s (LR).
What is the starting infusion rate for oxytocin?
1 to 2 mU/min.
How is oxytocin infusion increased if there is no response?
Gradually increase every 30 to 60 minutes by increments of 1 to 2 mU/min until contractions begin.
What is the first intervention for uterine hyperstimulation?
Stop the oxytocin (Pitocin) infusion immediately.
What position should the patient be placed in for uterine hyperstimulation?
Left side to improve blood flow to the uterus.
What IV intervention helps manage uterine hyperstimulation?
Administer an IV fluid bolus to dilute oxytocin levels.
How should oxygen be administered for uterine hyperstimulation?
By mask at 8 to 10 L/min.
What medication may be prescribed to relax the uterus in cases of uterine hyperstimulation?
Terbutaline.
What is the surest method to relieve tachysystole (excessive uterine contractions)?
Immediately discontinue the oxytocin infusion.
What should be done if unsure about uterine hyperstimulation management?
Err on the side of stopping the infusion rather than delaying and causing harm.
