For what complication should a nurse monitor a patient when an oxytocin infusion is used to induce labor?

NCL (MP) Nursing Officer - 2019

Obstetrics & Gynaecology

Medium

Appeared in: NCL (MP) Nursing Officer - 2019

Explanation

Oxytocin is a uterotonic agent used to induce or augment labor by stimulating uterine contractions.
A major risk of oxytocin administration is uterine hyperstimulation, which can lead to uterine tetany (tachysystole).
Tachysystole is defined as more than five contractions in a 10-minute period, averaged over 30 minutes.
Uterine tetany reduces blood flow to the placenta, which can cause fetal hypoxia and distress, evidenced by non-reassuring fetal heart rate patterns.
Other serious but rare complications of uterine tetany include placental abruption and uterine rupture.

Option A: While labor induction with oxytocin can cause intense pain, pain is an expected finding during labor and not considered a primary complication in the same way as a life-threatening condition like uterine tetany.
Option C: Hypoglycemia is not a known direct side effect of oxytocin. A more relevant, though less common, complication is water intoxication (hyponatremia) due to oxytocin's antidiuretic effect, especially when administered in high doses with large volumes of hypotonic IV fluids.
Option D: Umbilical cord prolapse is a mechanical obstetric emergency that occurs when the umbilical cord descends ahead of the fetal presenting part. It is most commonly associated with artificial or spontaneous rupture of membranes when the fetal head is not engaged in the pelvis. It is not a direct pharmacological effect of oxytocin.

Clinical Relevance

Nursing practice connection: Use the key finding related to Complications of Oxytocin Administration during Labor to guide bedside assessment, documentation, and the next nursing action.
The nurse's primary responsibility during an oxytocin infusion is continuous monitoring of uterine contraction patterns (frequency, duration, intensity) and the fetal heart rate (FHR).
Recognizing uterine tachysystole and initiating prompt interventions are critical nursing skills to prevent fetal compromise and ensure patient safety.
Failure to stop the oxytocin infusion during uterine tetany can lead to severe fetal acidemia, hypoxic-ischemic encephalopathy (HIE), or even fetal death.

How to Approach the Question

First, identify the core subject of the question: the complications of oxytocin use for labor induction.
Recall the primary action of oxytocin: it stimulates uterine muscle to contract.
Consider the potential negative effect of overstimulation. If the drug works 'too well,' it will cause excessive contractions.
Evaluate the options based on this mechanism. 'Uterine tetany' directly describes a state of excessive, sustained uterine contraction.
'Intense pain' is an expected part of labor, not a specific complication.
'Hypoglycemia' is related to blood sugar, which is not the primary system affected by oxytocin.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 55-74

E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 225-227