A client is being sent into the labor and birth unit for a serial induction of labor. The Bishop's score is 7. What would the nurse anticipate as the sequence of treatment planned for this client?
a. Administration of laminaria with EFM followed by amniotomy and oxytocin (Pitocin) infusion in a 12-hour period
b. Amniotomy on the first day in conjunction with EFM followed by oxytocin (Pitocin) infusion on the following clinical day
c. Administration of oxytocin (Pitocin) on the first day followed by amniotomy on the second clinical day
d. Administration of laminaria with EFM on the first day followed by oxytocin (Pitocin) infusion on the second day and evaluation of progress; on the third day, continued oxytocin (Pitocin) infusion with amniotomy
ANS: D
A serial induction looks at a progressive treatment plan that is based on the best outcome, that of a successful birth. Because the Bishop's score is 7, this indicates that certain conditions are not favorable for an induction. Therefore, the use of mechanical methods for cervical ripening maybe warranted. A serial induction is typically done over a 3-day period in which cervical ripening is followed by 2 days of Pitocin infusion, and on the last day an amniotomy is performed in conjunction with the infusion.
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