Physiological Integrity Q 20
In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia, the nurse should expect:
A. A painless delivery
B. Cervical effacement
C. Infrequent contractions
D. Progressive cervical dilation
Correct Answer: D. Progressive cervical dilation
The expected effect of Pitocin is cervical dilation. Oxytocin is indicated and approved by the FDA for two specific time frames in the obstetric world: antepartum and postpartum. In the antepartum period, exogenous oxytocin is FDA-approved for strengthening uterine contractions with the aim of successful vaginal delivery of the fetus.
Option A: Pitocin causes more intense contractions, which can increase the pain. 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 B: Cervical effacement is caused by pressure on the presenting part. During the later stages of pregnancy, the fetus’s head drops into the pelvis, pushing it against the cervix. This process stretches the cervix, causing it to thin and shorten. Measurement of effacement is usually in percentages. For example, when the cervix is 100% effaced, it means that it is completely thinned and shortened.
Option C: Infrequent contractions is opposite the action of Pitocin. Exogenous oxytocin causes the same response in the female reproductive system as that of endogenous oxytocin. Both types of oxytocin stimulate uterine contractions in the myometrium by causing G-protein coupled receptors to stimulate a rise in intracellular calcium in uterine myofibrils.