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Mrs. P., 36 weeks gestation, is having a CST with an oxytocin IV infusion pump. After two contractions, the uterus stays contracted. The best initial action of the nurse is to
a. help the client turn on her left side.
b. turn off the infusion pump
c. wait three minutes for the uterus to relax.
d. administer prn terbutaline sulfate (Brethine)
Correct Answer: B. When IV oxytocin is being used to stimulate uterine contractions in a contraction stress test, the oxytocin infusion si stopped if contractions occur more often than every two minutes or last longer than 60 seconds, if uterine tetany (remains contracted) takes place, or if continued fetal heart rate decelerations are noted.
Turning a client, in late pregnancy, on her left side will relieve pressure of the gravid uterus on the inferior vena cava; it will have no effect on a contracted uterus.
A contracted uterus reduces placental blood flow and the flow of oxygen to the fetus; this condition can result in fetal hypoxia so it must be resolved immediately.
It is possible that this tocholytic drug may be given to inhibit uterine contractions, but first the cause of the contraction must be eliminated.
Posted in: MCN NCLEX
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