Questions and Answers
What is the indication for Pitocin (oxytocin)?
For involution and prevention of hemorrhage, induction, and augmentation.
What is the dosage for induction of Pitocin (oxytocin)?
0.5-1 milliunits/min; increase by 1-2 milliunits/min every 30-60 minutes.
What are the nursing considerations before administering Pitocin (oxytocin)?
Assess fetal maturity, presentation, pelvic adequacy, uterine contractions, resting tone, and fetal heart rate.
What are some side effects of Pitocin (oxytocin)?
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Severe hypertension may occur if oxytocin follows administration of vasopressors.
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What should patients expect after receiving Pitocin (oxytocin)?
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What is the classification of Methergine?
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What is the indication for Methergine?
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What is the dosage and route for Methergine?
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What are some side effects of Methergine?
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What are the nursing considerations for administering Methergine?
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What should patients be advised regarding Methergine doses?
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What can excessive vasoconstriction result from when using Methergine?
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Study Notes
Pitocin (Oxytocin)
- Indication: Used to promote uterine involution, prevent hemorrhage, induce and augment labor.
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Dosage/Route:
- Induction: Start at 0.5-1 milliunits/min, increase by 1-2 milliunits/min every 30-60 minutes until contractions are established.
- For postpartum hemorrhage: Infuse 10 units at 20-40 milliunits/min, administer an additional 10 units after placenta delivery.
- Routes: Administered via IV or IM after delivery.
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Nursing Considerations:
- Assess fetal maturity, presentation, and pelvic adequacy prior to administration.
- Monitor uterine contractions and fetal heart rate continuously.
- If contractions exceed 50-65 mm Hg, lasting longer than 60-90 seconds, or significant fetal heart rate changes occur, stop infusion and position patient on left side.
- Monitor for water intoxication symptoms (drowsiness, confusion, headache).
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Side Effects/Adverse Reactions:
- Maternal side effects include hypotension, hyponatremia, and increased uterine motility.
- Adverse reactions can involve coma, seizures, uterine rupture and fetal intracranial hemorrhage.
- Drug Interactions: Severe hypertension may occur if administered after vasopressors.
- Patient Teaching: Expect menstrual-cramp-like contractions following administration.
Methergine
- Classification/Mechanism of Action: Falls under oxytocics; stimulates uterine and vascular smooth muscle to induce contractions.
- Indication: Used for the prevention and treatment of postpartum or post-abortion hemorrhage due to uterine atony or subinvolution.
- Dosage/Route: Administer 0.2 mg via intramuscular injection.
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Side Effects/Adverse Reactions:
- Common side effects include dizziness, headache, tinnitus, dyspnea, nausea, and arrhythmias.
- Severe adverse reactions can consist of stroke, hypertensive crisis, and allergic reactions.
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Nursing Considerations:
- Monitor BP, heart rate, and uterine response frequently.
- Notify healthcare provider if uterine relaxation is prolonged or changes in vaginal bleeding occur.
- Watch for signs of ergotism and manifestations of hypertensive crisis.
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Patient Teaching:
- Take medication as directed and report missed doses appropriately.
- Advise caution against smoking and potential sensitivity increases with infections.
- Encourage open communication with healthcare providers regarding all medications being taken.
- Drug Interactions: Excessive vasoconstriction risk when used with nicotine, other vasopressors, or beta-blockers; grapefruit juice may alter drug levels.
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Description
This quiz covers the indications, dosage, nursing considerations, and side effects associated with the use of Pitocin (Oxytocin). It is essential for nursing students to understand the proper administration and monitoring protocols for this medication during labor and postpartum care.
