Page 867 - Saunders Comprehensive Review For NCLEX-RN

10. Have emergency equipment readily accessible.
11. Document the dose of the medication and the time the
medication was started, increased, maintained, and
discontinued; document the client’s response.
12. Keep the client and family informed of the client’s
progress.
13. Calculating an oxytocin drip (Box 28-3)

Priority Nursing Actions

Hypertonic Contractions or a Nonreassuring Fetal Heart Rate during
Oxytocin Infusion
1. Stop the oxytocin infusion.
2. Turn the client on her side, stay with the client, and ask another
nurse to contact the obstetrician (OB).
3. Increase the flow rate of the intravenous (IV) solution that does
not contain the oxytocin.
4. Administer oxygen, 8 to 10 L/minute, by snug face mask.
5. Assess maternal vital signs; fetal heart rate and patterns; and
frequency, duration, and force of contractions.
6. Document the event, actions taken, and the response.

Reference

Lowdermilk et al. (2016), p. 784.

VII. Medications Used to Manage Postpartum Hemorrhage (Box 28-4)
A. Ergot alkaloid
1. Description
a. Methylergonovine maleate is an ergot
alkaloid.
b. Directly stimulates uterine muscle,
increases the force and frequency of
contractions, and produces a firm
tetanic contraction of the uterus

c. Can produce arterial

vasoconstriction and vasospasm of the
coronary arteries
d. An ergot alkaloid is administered
postpartum and is not administered
before the birth of the placenta.
2. Uses
a. Postpartum hemorrhage
b. Postabortal hemorrhage resulting from
atony or involution
3. Adverse effects and contraindications
a. Can cause nausea, uterine

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