During labor induction with oxytocin, the fetal heart rate baseline is in the 140s with moderate variability. Contraction frequency is assessed to be every 2 minutes with duration of 60 seconds, of moderate strength to palpation
Based on this assessment, the nurse should take which action?
a. Increase oxytocin infusion rate per physician's protocol.
b. Stop oxytocin infusion immediately.
c. Maintain present oxytocin infusion rate and continue to assess.
d. Decrease oxytocin infusion rate by 2 mU/min and report to physician.
ANS: c
Feedback
a. Increasing the oxytocin infusion could result in uterine hyperstimulation.
b. The uterine contraction pattern is normal, and oxytocin infusion should be maintained, not stopped.
c. Correct. Maintain present oxytocin infusion rate and continue to assess is the correct response, as this question describes a normal uterine contraction pattern.
d. The uterine contraction pattern is normal, and oxytocin infusion should be maintained, not stopped or decreased.
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