23.03 Uterine Stimulants

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Overview

  1. Oxytocin is a naturally occurring hormone that is released during labor and when breastfeeding
  2. Stimulates uterine contractions and increases intensity, strength, and duration of contractions
  3. Synthetic form given as a continuous infusion IV for labor induction or in postpartum hemorrhage

Nursing Points

General

  1. Uses
    1. Induce/augment labor
    2. Help control PPH
    3. Incomplete abortions
  2. Causes extremely painful uterine contractions

Assessment

  1. Monitoring
    1. Frequent monitoring of mom
      1. Contractions
        1. Monitor and chart frequency, duration, intensity
        2. Watch for hypertonic contraction – a single contraction lasting >2 min or >5 contractions in 10 min
      2. Frequent I&O
        1. Side effect is water retention
    2. Frequent fetal monitoring
      1. Continuous fetal monitoring
    3. Assess for uterine atony
      1. Give pitocin to stimulate contractions

Therapeutic Management

  1. Order set – base monitoring, titrations, and interventions based up on this protocol
  2. If the baby has non reassuring fetal heart tones
    1. STOP infusion
    2. Turn mom on left side
    3. O2
    4. Assess baby and mom to see if changes occurred
    5. Notify MD

Nursing Concepts

  1. Pharmacology
  2. Safety

Patient Education

  1. Expect to feel pain/contractions
  2. Purpose of medication
  3. Plan of care
    1. Epidural
    2. Monitoring

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