A client in labor is receiving oxytocin (Pitocin) by intravenous infusion to stimulate uterine contractions. Which of the following findings indicates that the rate of the infusion needs to be decreased?
1. Increased urinary output
2. A fetal heart rate of 180 beats/min
3. Three contractions occurring in a 10-minute period
4. Adequate resting tone of the uterus palpated between contractions
2
Rationale: A normal fetal heart rate is 120 to 160 beats/min. Acute hypoxia is a common cause of fetal tachycardia. The dosage of oxytocin should be decreased in the presence of fetal tachy-cardia, which can occur from excessive uterine activity. The goal of labor augmentation is to achieve three good-quality contractions (appropriate intensity and duration) in a 10-minute peri-od. The uterus should return to resting tone between contractions, and there should be no evi-dence of fetal distress. Increased urinary output is unrelated to the use of oxytocin.
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