Induction of Labour
Access the module for induction/augmentation of labour with Oxytocin. Practice quiz below.
Quiz
- If the FHR has been normal upon auscultation, you only need to apply the EFM at the time you begin the oxytocin induction. True or False
Answer
True
- ) It may take ____ to ____ minutes to see a response once the oxytocin is adjusted down or off due to tachysystole (half life of oxytocin).
Answer
6 to 8
- ) A Bishop score of 7 is adequate to start an oxytocin induction. True or False
Answer
False
- Many of the medications given in labour are compatible with oxytocin. A port line may be used as long as long as the line is clearly marked as oxytocin. True or False
Answer
False
- The PCP leaves an order to start the oxytocin as per protocol. You mix 30 units Syntocinon in 500 mLs N/S. The patient is a grandmultip. The infusion should be started at ____ mU/min, which equals _____ mLs/hr. You will adjust the rate by _____ mU/min (= to _____ mLs/hr) every _____minutes until the contractions are adequate.
Answer
The PCP leaves an order to start the oxytocin as per protocol. You mix 30 units Syntocinon in 500 mLs N/S. The patient is a grandmultip. The infusion should be started at .3 mU/min, which equals .3 mLs/hr. You will adjust the rate by 1 mU/min (= to 1 mLs/hr) every 30 minutes until the contractions are adequate.
- Before starting the infusion, what risks should the PCP discuss with the patient?
Answer
Failed induction resulting in C/S, chance of operative vaginal delivery, tachysystole, with and without
FHR changes, chorioamnionitis, prolapsed cord with ARM, preterm infant being delivered if dates are
off, uterine rupture & water intoxication.
- The labour floor is really busy and you cannot find a nurse to do your independent double nurse check when mixing the syntocinon. You feel it is OK to mix and infuse the medication as the drug monograph states a double check is only required when possible. True or False
Answer
False
- It takes _______ to _____ minutes to achieve a uterine steady state with oxytocin.
Answer
30 to 40
- A patient had her cervidil removed at 1200. It is now 1220 and the PCP wants the oxytocin initiated. What is the period of time that must lapse between cervidil removal and initiation of the infusion?
Answer
30 minutes
- A patient is having contractions every 2-3 minutes, lasting 20 seconds, palpating mild. Do you increase the oxytocin? Why or why not?
Answer
As they contractions are only lasting 20 seconds, the rate may be turned up (ineffective contractions) as
long as the FHR is normal and there is adequate resting tone between contractions. However, it is also
OK to wait to see if the contractions lengthen and if not, turn the rate up at the next 30 minute mark.
- Written consent by the patient is required to initiate an induction. True or False
Answer
True
- During an induction/augmentation, BP must be monitored every _____ and pulse every _____.
Answer
During an induction/augmentation, BP must be monitored every hour and pulse ever 15 minutes.
- An accurate I&O is not necessary until the patient has been on oxytocin for greater than 24 hours as this is when water intoxication may occur. True or False
Answer
False
- After initiating an oxytocin infusion, the patient is able to ambulate once…
Answer
…. the rate of infusion has been constant for 1 hour and the FHR is normal
- A patient is on 20 mu/min of oxytocin, with contractions every 2-3 minutes, lasting 60 seconds, palpating moderate. SROM occurs. Should the oxytocin be turned down? Why or why not?
Answer
Consideration should be given to decreasing the rate of infusion as the patient has adequate
contractions. A ROM generally will cause an increase in contractions. If the patient does not have
adequate contractions, the rate may be left as is. Monitor the contractions carefully to ensure
tachysystole does not occur.
- When the patient is ambulating in the halls, you can document on the labour record that she is ambulating as a reason why the FHR/Contraction pattern was not checked. True or False
Answer
False
- The most common sign of a uterine rupture is ____________, followed by….
Answer
The most common sign of a uterine rupture is Abnormal FHR, followed by… Abnormal uterine pain, vaginal bleeding or hematuria, elevated presentation of fetal presentation upon PV, easier abdominal palpation of fetal part.
- What important safety feature should you inform your patient about regarding the oxytocin infusion on the pump?
Answer
That the oxytocin line should never be disconnected from the pump before being disconnected from her, unless she has already delivered her baby.