A client has been in labor for 10 hours. Her contractions have become hypoactive and slowed in duration. The fetus is at 0 station, cervix is dilated 8 cm and effaced 90%. The physician orders an oxytocin (Pitocin) infusion to be started at once. The RN begins the oxytocin infusion.
It is important that the RN discontinue the infusion if which one of the following occur?
A . The client’s contractions are <2 minutes apart.
B . Duration of the contractions are 60 seconds.
C . The uterus relaxes between contractions.
D . The client complains that she is tired.
Answer: A
Explanation:
(A) It is very important that there is a resting phase or relaxation period between the contractions. During this period, the uterus, placenta, and umbilical vessels re-establish blood flow. No resting phase between contractions can lead to fetal bradycardia, fetal hypoxia, and acidosis. It can also result in a tetanic contraction, which can cause uterine rupture.
(B) The goal of the oxytocin infusion is to help establish a contraction pattern lasting 45C60 seconds occurring every 2 minutes and a uterine tonus of 60C70 mm Hg.
(C) This choice is correct. The uterus has time to recover from the contraction.
(D) The client’s tiring is no indication to stop the infusion. She will be tired even without the infusion.