Page 865 - Saunders Comprehensive Review For NCLEX-RN

3. Uterine tachysystole (≥ 12 uterine contractions in 20
minutes without an alteration in the fetal heart rate
pattern)
4. Hyperstimulation of the uterus
5. Fetal passage of meconium
6. Contraindications (Box 28-2)

D. Interventions

1. Monitor maternal vital signs, fetal heart rate pattern,
and status of pregnancy, including indications for
cervical ripening or the induction of labor,
contraindications, adverse effects, signs of labor or
impending labor, and the Bishop score (see Chapter
23, Table 23-2 for information about the Bishop score).
2. Have the client void before administration of
medication and then have her maintain a supine with
lateral tilt or side-lying position for 30 to 60 minutes
(gel) up to 2 hours (insert) after administration,
depending on the medication administered.
3. Treatment is discontinued when the Bishop score is 8
or more (cervix ripens) or an effective contraction
pattern is established (3 or more contractions in a 10-
minute period); in addition, signs of adverse effects
indicate that the treatment needs to be discontinued.
4. Follow agency protocol for the induction of labor if
cervical ripening has occurred and labor has not
begun; oxytocin may be initiated if needed 6 to 12
hours after discontinuation of prostaglandin therapy.

VI. Uterine Stimulants (Oxytocics): Oxytocin

A. Description
1. Oxytocin stimulates the smooth muscle of the uterus
and increases the force, frequency, and duration of
uterine contractions.
2. Oxytocin also promotes milk letdown.
3. For induction of labor, oxytocin is administered by the
IV route (other route of administration is
intramuscular); if injecting intramuscularly,
aspiration is necessary to avoid injection into a blood
vessel.
4. Magnesium sulfate should be readily accessible in case
relaxation of the myometrium is necessary.
5. Minimal cervical change usually is noted until the
active phase of labor is achieved.
B. Uses
1. Induces or augments labor
2. Controls postpartum bleeding

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