The physician has ordered an intravenous infusion of Pitocin for the induction of labor. When caring for the obstetric client receiving intravenous Pitocin, the nurse should monitor for:
A. Maternal hypoglycemia
B. Fetal bradycardia
C. Maternal hyperreflexia
D. Fetal movement
Correct Answer: B. Fetal bradycardia
The client receiving Pitocin should be monitored for decelerations. It is essential to monitor patient fluids (both intake and outtake) while administering oxytocin, as well as the frequency of uterine contractions, patient blood pressure, and heart rate of the unborn fetus.
Option A: Oxytocin is primarily used by the obstetrician and the labor and delivery nurses. Healthcare workers who do prescribe this hormone should be familiar with its side effects. An inappropriate dosage of oxytocin can lead to dangerous tachycardia, arrhythmias, and myocardial ischemia. High dosages of oxytocin can cause uterine rupture, hypertonicity, and spasms.
Option C: If oxytocin is given in doses too large or even slowly during 24 hours, the medication can exhibit an antidiuretic effect resulting in extreme water intoxication. This excessive dosing can result in coma, seizures, and even death in the mother.
Option D: When oxytocin is given to women who are in the first or second stages of labor, or to women to cause induction of labor, uterine rupture, as well as maternal subarachnoid hemorrhages, maternal death, and even fetal death, can result.