Which assessment is most important for the nurse to do before the administration of oxytocin for labor induction?
7.4.1 Indications– Induction of labour. Show
7.4.2 Risks of using oxytocin during labour– Maternal risk: uterine rupture, especially in a scarred uterus, but in a unscarred uterus as well, particularly if it is overdistended (multiparity, polyhydramnios, multiple pregnancy) or if there is major foeto-pelvic disproportion. 7.4.3 Contra-indications to the use of oxytocin during labour– Obvious foeto-pelvic disproportion, including malpresentation (brow, transverse, etc.). 7.4.4 Situations requiring special precautions– Prior single low transverse caesarean section. These factors increase the risk of uterine rupture. Oxytocin may be used provided the following precautions are respected: 7.4.5 Conditions for oxytocin use– Given
the risk to both mother and foetus, use of oxytocin during labour requires: In the event of foetal distress, uterine
hyperkinesia (more than 5 contractions in 10 minutes) or uterine hypertony (absence of uterine relaxation): stop the oxytocin. Table 7.2 - Use of oxytocin
What should the nurse do before administering oxytocin?The nurse must have sound knowledge about the physiology of uterine contractions and the phamacodynamics and pharmacokinetics of oxytocin. In addition, the nurse must be proficient at maternal-fetal assessment, including palpation of contractions and interpretation of electronic fetal heart rate monitor tracings.
Which criteria must be in place before beginning an oxytocin induction?Oxytocin Infusion may be utilized when there is a favorable cervix and a Bishop score of six (6) or greater: a) If cervix is unfavorable/Bishop Score is less than six (6) see AHS Induction of Labour: Cervical Ripening Guideline.
What nursing interventions should you perform prior to starting induction of labor?Monitor fetal heart tones immediately before, during, and after the procedure. Observe and record color, amount, and odor of amniotic fluid; time of procedure; cervical status; and materbal temperature. Take and record the client's temperature every 2 hours to assess for infection. Monitor for the onset of labor.
What should you assess after giving oxytocin?Monitor any signs of fetal distress or asphyxia, such as decreased fetal heart rate, arrhythmias, meconium discharge, or decreased or absent fetal movements. Report these signs to the physician or nursing staff immediately. Assess maternal blood pressure periodically and compare to normal values (See Appendix F).
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