Purpose of the tool: This tool describes the key perinatal safety elements with examples for the safe administration of oxytocin during labor. The key elements are presented within the framework of the Comprehensive Unit-based Safety Program
(CUSP). Who should use this tool: Nurses, physicians, midwives, pharmacists, and other labor and delivery (L&D) unit staff involved in the preparation and administration of oxytocin during labor. How to use this tool: Review the key perinatal safety elements with L&D leadership and unit staff to determine how elements will be implemented on your L&D unit. Consider any existing facility policies or processes related to oxytocin use. Consider using
preprinted orders, standing orders, and staff training to support implementation. A sample of how some of these key perinatal safety elements can be incorporated into a unit approach to safe oxytocin administration is provided in the Appendix of this tool. A sample process and forms for a committee review are available at the Council on Patient Safety in Women’s Health Care, www.safehealthcareforeverywoman.org. In the context of oxytocin use, this includes staff alertness for early signs of fetal or maternal distress, and knowing the plan for a timely response to prevent
further deterioration. Every effort was made to ensure the accuracy and completeness of this resource. However, the U.S. Department of Health and Human Services makes no warranties regarding errors or omissions and
assumes no responsibility or liability for loss or damage resulting from the use of information contained within. Examples of gestational dating documentation include the following: Standing Orders for Response to Complications: For tachysystole, the following should be implemented as standing physician orders so that nurses can implement without delay: For Category I FHR pattern and tachysystole: Note: Consider any fluid restrictions the patient may have. If uterine activity does not return to normal after 10 minutes, decrease the oxytocin rate by at least half; if uterine activity has not returned to normal after 10 more minutes, discontinue the oxytocin until uterine activity is less than five contractions in 10 minutes. For Category II and III FHR and tachysystole: Note: Consider any fluid restrictions the patient may have. If no response, administer terbutaline 0.25 mg SC. Discontinue oxytocin infusion and notify provider for— For decreased urine output or maternal hypotension, administer 500 cc of LR by IV bolus, and notify provider of response to bolus. Resumption of oxytocin after discontinuation:
[Note: some facilities choose to require a provider order to restart oxytocin] If oxytocin has been discontinued for less than 30 minutes— Note: Do not start oxytocin on patients who are < 4 hours post-insertion of misoprostol. Note: Do not start oxytocin on patients who are < 4 hours post-insertion of misoprostol. Page last reviewed May 2017 Page originally created April 2017 Internet Citation: Safe Medication Administration: Oxytocin. Content last reviewed May 2017. Agency for Healthcare Research and Quality, Rockville, MD. What are the adverse effects of oxytocin?Side Effects. Confusion.. convulsions (seizures). difficulty in breathing.. fast or irregular heartbeat.. headache (continuing or severe). hives.. pelvic or abdominal pain (severe). skin rash or itching.. When caring for a client receiving oxytocin therapy the nurse must continuously evaluate?Question 16 Explanation: A client receiving oxytocin therapy requires continuous monitoring of maternal vital signs, fluid intake and output, electronic fetal monitoring, and uterine contractions.
What serious adverse effects are associated with oxytocin Pitocin )? Select all that apply?Pitocin may cause serious side effects including:. fast, slow or uneven heart rate,. excessing bleeding long after childbirth,. severe headache,. blurred vision,. pounding in your neck or ears,. confusion,. severe weakness, and.. feeling unsteady.. What is the most significant risk to a client receiving oxytocin for labor induction?One risk is that when oxytocin is used, the uterus may be overstimulated. This may cause the uterus to contract too often. Too many contractions may lead to changes in the fetal heart rate. If there are problems with the fetal heart rate, oxytocin may be reduced or stopped.
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