A patient has received two doses of dinoprostone (Prepidil) to initiate labor. It has been 6 hours since the last dose
The nurse assesses the patient and notes that the cervix is ripe and dilated to 4 cm, but contractions are diminishing in intensity and frequency. What will the nurse expect to do?
a. Administer oxytocin.
b. Monitor urine output.
c. Prepare for a cesarean section.
d. Watch closely for fetal distress.
ANS: A
Once the cervix is ripe and labor has occurred, labor should progress, with contractions increasing in duration and frequency. This woman is showing signs of stalled labor and, because the cervix is ripe, can be induced with oxytocin. Large doses of oxytocin can cause water intoxication, which is not a risk at this point in this patient. There is no indication for a cesarean section at this point. The risk of fetal distress is not increased at this point.
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