Oxytocin intravenous infusion in labor should be discontinue if - - RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Obstetrics & Gynaecology

Medium

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

A fetal heart rate (FHR) of 90 beats per minute (bpm) is classified as fetal bradycardia, as the normal range is 110-160 bpm.
Fetal bradycardia is a non-reassuring fetal heart rate pattern, indicating potential fetal distress or hypoxia.
According to clinical guidelines, the presence of a persistent non-reassuring fetal heart rate pattern is a primary indication for the immediate discontinuation of the oxytocin infusion (SRC_3208).
Stopping the oxytocin helps to reduce the frequency and intensity of uterine contractions, which can improve uteroplacental blood flow and fetal oxygenation.

Option A: Oxytocin has an antidiuretic effect due to its similarity to vasopressin, which leads to water retention and decreased urinary output, not increased (SRC_3208).
Option C: A pattern of 3 contractions in 10 minutes is generally considered a therapeutic goal for labor augmentation and represents adequate, not excessive, uterine activity.
Option D: A systolic blood pressure of 130 mm Hg is within an acceptable range for a woman in labor and is not, by itself, an indication to discontinue oxytocin.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Indications for discontinuing oxytocin infusion during labor as background academic context rather than a clinical decision trigger.
The nurse's primary role during oxytocin administration is continuous monitoring of both the fetal heart rate and the uterine contraction pattern to ensure fetal well-being and prevent complications.
Immediate recognition of and intervention for a non-reassuring FHR pattern, such as bradycardia, is a critical patient safety measure to prevent fetal injury.
Discontinuing oxytocin is the first step in intrauterine resuscitation for fetal distress caused by uterine tachysystole.

How to Approach the Question

Identify the core of the question: It asks for a clinical sign that necessitates stopping an oxytocin infusion during labor.
Recall the purpose and primary risks of oxytocin: It strengthens contractions but can cause uterine hyperstimulation (tachysystole), which may reduce blood flow to the fetus and lead to fetal distress.
Review the normal parameters for labor: A normal Fetal Heart Rate (FHR) is 110-160 bpm. A normal contraction pattern is typically 3-5 contractions in 10 minutes.
Evaluate each option against these safety parameters:
A: Is increased urine output an expected adverse effect? No, oxytocin causes water retention and decreased output.
B: Is an FHR of 90 bpm safe? No, this is significant bradycardia and a clear sign of fetal distress.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 83-95