Endocrine Drugs and Medications Q 32
Julia is a mother who is receiving oxytocin therapy. The nurse must continuously evaluate:
A. Membrane integrity
B. Uterine contractions
C. Cervical dilation
D. Cervical effacement
Correct Answer: B. Uterine contractions
A client receiving oxytocin therapy requires continuous monitoring of maternal vital signs, fluid intake and output, electronic fetal monitoring, and uterine contractions. It is essential to monitor patient fluids (both intake and outtake) while administering oxytocin, as well as the frequency of uterine contractions, patient blood pressure, and heart rate of the unborn fetus. When oxytocin is released, it stimulates uterine contractions, and these uterine contractions, in turn, cause more oxytocin to be released; this is what causes the increase in both the intensity and frequency of contractions and enables a mother to carry out vaginal delivery completely.
Option A: When oxytocin is given to women who are in the first or second stages of labor, or to women to cause induction of labor, uterine rupture, as well as maternal subarachnoid hemorrhages, maternal death, and even fetal death, can result. If oxytocin is given in doses too large or even slowly during 24 hours, the medication can exhibit an antidiuretic effect resulting in extreme water intoxication; this can result in coma, seizures, and even death in the mother.
Option C: Oxytocin is the commonest induction agent used worldwide. It has been used alone, in combination with amniotomy or following cervical ripening with other pharmacological or non-pharmacological methods. Prior to the introduction of prostaglandin agents oxytocin was used as a cervical ripening agent as well.
Option D: Comparison between the use of intravenous oxytocin alone with a combination of oxytocin and either vaginal or intracervical PGE2 demonstrate that prostaglandins result in a significantly lower cesarean delivery rate and an increased proportion of vaginal deliveries within 24 hours.