Select the situation that describes the safest administration of oxytocin induction and cervical ripening agents
a. Concurrent use of oxytocin and dinoprostone (Cervidil)
b. Misoprostol (Cytotec) 25 mcg, followed in 4 hours by oxytocin induction in vaginal birth after cesarean section (VBAC) client
c. Dinoprostone (Cervidil) 10 mg in place for 12 hours followed by oxytocin induction in 1 hour
d. Maximum dose of dinoprostone (Prepidil) 2 mg/24 hr followed in 4 hours by oxytocin induction
ANS: C
Dinoprostone (Cervidil) in a 10-mg, time-release insert may be left in place for up to 12 hours and oxytocin induction can be safely started 1 hour after insert is removed. Oxytocin and cervical ripening agents cannot be administered at the same time. Misoprostol (Cytotec) is contraindicated in a women with previous cesarean. The maximum dose of dinoprostone (Prepidil) 1.5 mg/24 hr.
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