During labour inj. Oxytocin has to be administered intravenously in which of the following ways

NHM UP Staff Nurse-2021 Shift-2nd

Obstetrics & Gynaecology

Easy

Appeared in: NHM UP Staff Nurse-2021 Shift-2nd

Explanation

Oxytocin is a potent uterotonic agent used for labor induction and augmentation, requiring precise administration.
It is given as a controlled intravenous (IV) infusion, ideally with an infusion pump, to allow for careful titration of the dose.
This method ensures that uterine activity can be managed to produce effective contractions while avoiding hyperstimulation.
Oxytocin has a short half-life of 3-5 minutes, so an infusion can be stopped quickly if adverse effects like uterine tachysystole or fetal distress occur, allowing its effects to rapidly decrease.

Option A: Administering oxytocin as a bolus (a single, large dose) is strictly contraindicated during labor.
Option C: A fast push is equivalent to a bolus and carries the same significant risks of uterine hyperstimulation, fetal distress, and potential uterine rupture.
Option D: The question specifically asks for the intravenous method. Furthermore, the intramuscular route provides less predictable absorption and is not suitable for the fine control needed during labor induction.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of the safe and appropriate method for administering intravenous oxytocin for labor induction or augmentation as background academic context rather than a clinical decision trigger.
Oxytocin is a high-alert medication in obstetrics due to its potential for causing significant harm if not administered correctly. Nurses must adhere strictly to protocols.
The nurse's primary responsibilities include continuous electronic fetal monitoring and assessment of uterine contractions to prevent tachysystole (more than 5 contractions in 10 minutes).
What if? If uterine tachysystole occurs, the nurse's immediate actions are to stop the oxytocin infusion, turn the patient to her side, administer oxygen if ordered, and notify the healthcare provider. A tocolytic agent may be ordered to relax the uterus.

How to Approach the Question

Identify the keywords in the question: "Oxytocin," "intravenously," and "during labour."
Recall the primary use of oxytocin in labor: to induce or augment uterine contractions.
Consider the safety implications. Oxytocin is a powerful drug that can cause harm if given too quickly or in too high a dose.
Evaluate the administration options based on the need for control. An 'infusion' allows for slow, controlled, and adjustable delivery.
Eliminate 'bolus' and 'fast push' as they represent rapid, uncontrolled administration, which is dangerous in this context.
Eliminate 'intramuscular' as it's a different route and doesn't offer the precise, immediate control of an IV infusion required for labor management.

Concept Tested & Keywords

Concept Tested: The question tests the knowledge of the safe and appropriate method for administering intravenous oxytocin for labor induction or augmentation.
Stem keywords: labour, inj. Oxytocin, administered intravenously
Lead-in keywords: in which of the following ways
Negative lead-in flag: false

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E6 Obstetrics Williams p. 83-95

E6 Pharmacology Nursing Lilley 11e Part 2 p. 246-248