When uterus is overstimulated by oxytocin, which of following signs the nurse can identify?

AIIMS Bhatinda NO - 2019

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

Oxytocin is a potent medication used to induce or augment labor by stimulating uterine contractions.
Overstimulation occurs when the dose is too high or the uterus is overly sensitive, leading to excessive uterine activity.
This excessive activity manifests as tetanic contractions, which are prolonged (lasting more than 90-120 seconds), too frequent (more than 5 in 10 minutes), or have an inadequate relaxation period (less than 30-60 seconds) between them.
Tetanic contractions are dangerous because they reduce or cut off blood flow to the placenta, leading to fetal hypoxia and distress.
The primary goal of nursing management is to recognize these signs early and intervene immediately by stopping the oxytocin infusion.

Option B: Bradycardia (a slow heart rate) is not a direct maternal sign of oxytocin overstimulation. It is a potential sign of fetal distress, which is a secondary complication resulting from the reduced placental blood flow caused by tetanic contractions.
Option C: Increased temperature is not associated with oxytocin administration. It is a classic sign of infection, such as chorioamnionitis, which is a separate obstetric complication.
Option D: Headache is not a primary sign of uterine overstimulation. It can be a symptom of water intoxication, a rare but serious side effect of prolonged, high-dose oxytocin infusion due to its antidiuretic properties. However, tetanic contraction is the direct and immediate sign of uterine hyperstimulation.

Clinical Relevance

Nursing practice connection: Knowing Adverse effects of oxytocin administration during labor helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing uterine hyperstimulation is a critical nursing responsibility during labor induction or augmentation with oxytocin.
Immediate cessation of the oxytocin infusion is the priority nursing action to prevent fetal compromise and potential uterine rupture.
Nurses must meticulously monitor both the uterine contraction pattern (frequency, duration, intensity, resting tone) and the fetal heart rate response throughout oxytocin administration.

How to Approach the Question

First, identify the core of the question: it asks for a direct sign of uterine overstimulation by oxytocin.
Recall the primary function of oxytocin: to cause uterine contractions.
Reason what 'overstimulation' would mean in this context: an excessive or exaggerated version of the primary function.
Evaluate the options: 'Tetany contraction' describes an excessive, prolonged contraction, which directly relates to overstimulation of the uterus.
Consider the other options. Bradycardia is a heart rate issue, more likely fetal than maternal in this context, and a consequence, not a direct sign. Increased temperature points to infection. Headache is a systemic, not uterine-specific, sign and is related to a different, rarer side effect of oxytocin.
Conclude that tetanic contraction is the most direct and specific sign of uterine overstimulation.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 55-74