Question

The client is scheduled for an oxytocin challenge exam using 10 units of oxytocin (Pitocin) in \(1000 \mathrm{~mL}\) of intravenous fluid. Which action by the nurse would ensure safe administration of oxytocin (Pitocin)? A. The nurse inserts a Foley catheter. B. The nurse checks the urinary output every hour. C. The nurse obtains an intravenous infusion pump from central supply. D. The nurse administers an anti-emetic prior to beginning the infusion.

Short answer

Answer: C. The nurse obtains an intravenous infusion pump from central supply.

Step-by-step solution

Understand the oxytocin challenge exam and administration of oxytocin (Pitocin)

The oxytocin challenge exam, also known as a contraction stress test, is performed to evaluate the fetal heart rate response to contractions induced by oxytocin (Pitocin). Oxytocin (Pitocin) is administered intravenously to induce contractions, and the fetal heart rate is monitored during the test. Safe administration of oxytocin (Pitocin) is essential during this procedure.

Analyze option A

Option A is about inserting a Foley catheter. A Foley catheter is used to drain urine from the bladder, which may not directly be related to the safe administration of oxytocin. This option may not be the most appropriate action to ensure the safe administration of Pitocin.

Analyze option B

Option B is about checking the urinary output every hour. While monitoring urinary output is important for overall patient care, it may not have a direct impact on the safe administration of oxytocin. This may not be the most appropriate action in this case.

Analyze option C

Option C is about obtaining an intravenous infusion pump from central supply. An intravenous infusion pump is used to regulate the flow rate of intravenous fluids, including medications such as oxytocin. This device can ensure accurate and controlled administration of oxytocin, which is critical for patient safety. This option seems to be the most appropriate action for ensuring the safe administration of Pitocin.

Analyze option D

Option D is about administering an anti-emetic prior to beginning the infusion. Anti-emetics are used to prevent or treat nausea and vomiting, which may not be directly related to the safe administration of oxytocin. This option may not be the most appropriate action in this case.

Identify the correct action

Based on the analysis of each option, the correct action by the nurse to ensure the safe administration of oxytocin (Pitocin) during an oxytocin challenge exam is: C. The nurse obtains an intravenous infusion pump from central supply.

Key concepts

Intravenous Infusion

In an oxytocin challenge exam, the administration of oxytocin (Pitocin) is achieved through an intravenous infusion. Intravenous infusion refers to the delivery of liquid substances directly into a vein. This method allows medications like oxytocin to quickly enter the bloodstream.

Using an intravenous infusion pump, the nurse can precisely control the flow of medication and fluids. This ensures that the patient receives the correct dosage at a steady rate, preventing any sudden spikes or drops. This level of control is crucial when dealing with potent medications like oxytocin.

In the context of this exam, the intravenous infusion must be carefully monitored. An infusion pump helps in maintaining a constant flow rate, enhancing both the safety and effectiveness of the administration.

By utilizing an infusion pump for such procedures, nurses can:

• Ensure accurate dosage of medication.
• Maintain a steady and controlled flow.
• Reduce the risk of complications associated with manual infusion.

Fetal Heart Rate Monitoring

Fetal heart rate monitoring is a vital component of the oxytocin challenge exam. This process involves closely observing the baby's heart rate while the mother undergoes contractions induced by oxytocin.

The fetal heart rate gives healthcare providers essential information about the baby's health and well-being. It allows them to assess how the baby is responding to the stress of contractions, ensuring that the baby is tolerating the procedure well.

Monitoring is performed using either an external device placed on the mother's abdomen or an internal device connected to the baby. These monitors track the heart rate patterns and alert healthcare providers to any signs of distress.

Key aspects of fetal heart rate monitoring include:

• Detection of abnormal heart rate patterns.
• Assessment of the baby's response to contractions.
• Ensuring timely intervention if any issues arise.

Contraction Stress Test

The contraction stress test, or oxytocin challenge exam, is a specialized medical test. It evaluates how the fetus responds to the stress of uterine contractions, which are stimulated using oxytocin (Pitocin).

During the test, low doses of oxytocin are carefully administered to induce contractions. The goal is to generate contractions similar in pattern to those that occur during labor. This enables healthcare providers to observe the baby's heart rate response.

If the baby's heart rate reacts well to the contractions, it might indicate that the baby can handle the stresses of labor. However, if there are any negative changes in heart rate, further assessments might be necessary.

The contraction stress test can provide insights into:

• The baby's ability to withstand labor.
• Potential risks during childbirth.
• The overall health status of the fetus.