Question

You have been assigned to care for a patient who is to receive an intravenous infusion of oxytocin to induce labor. The patient was admitted to the hospital 2 days ago for dehydration related to the flu.

What information should you obtain before starting the drug therapy?

Is the patient’s recent dehydration a consideration? If so, in what way?

Is any special equipment needed to administer oxytocin?

What monitoring should be done during oxytocin infusion?

For what complications that may require infusion to be stopped should you assess the patient?

Answer 1

1. INFORMATION THAT SHOULD BE OBTAINED BEFORE STARTING DRUG THERAPY:

Following factors should be assessed

• The patient’s medical and pregnancy history.
• Gestational age of the fetus i.e the number of weeks the baby present in the uterus.
• Estimated fetal weight.
• The fetal movements.
• Status of the cervix.

2.Yes dehydration should be taken into consideration as dehydration may leads to decrease in blood volume. This decrease leads to elevation of oxytocin level present in our blood. This rise of oxytocin can then trigger contractions of uterus.

3. EQUIPMENT NEEDED TO ADMINISTER OXYTOCIN

• Intravenous infusion pump
• Normal saline (NS) or lactated Ringer's (LR) solution
• Vials of oxytocin and syringes

4. MONITORING DONE DURING OXYTOCIN INFUSION :

1. Maternal vital signs,
2. Fetal heart rate, and
3. Frequency, duration, and intensity of uterine contractions

should be continuously monitored

5. COMPLICATIONS

The complications that require infusion to be stopped are :

• Uterine hyperstimulation:mother's uterine contractions become more ferquent .
• Hypertonic uterine contraction = contraction duration > 90 sec
• Elevated uterine resting tone : uterine resting tone means uterine pressure in relaxed state.In this case uterine pressure > 20 mm of Hg.
• Abnormal fetal heart rate patterns.