ATI Active Learning Template (Medication) -
Oxytocin (Pitocin)
ATI Active Learning Template (Medication) -
Oxytocin (Pitocin)
Category/Classification:
● Therapeutic: hormones
● Pharmacologic: uterine stimulants; ox
...
ATI Active Learning Template (Medication) -
Oxytocin (Pitocin)
ATI Active Learning Template (Medication) -
Oxytocin (Pitocin)
Category/Classification:
● Therapeutic: hormones
● Pharmacologic: uterine stimulants; oxytocics
Review Module: ATI Pharmacology Chapter 32 - Medications Affecting Labor & Delivery
Expected Pharmacological Action:
Action: Stimulates uterine smooth muscle, producing uterine contractions similar to those in
spontaneous labor. Has vasopressin and antidiuretic effects.
Therapeutic Effects: Induction of labor. Control of postpartum bleeding.
Therapeutic Use:
IV: Induction of labor at term.
IV: Facilitation of threatened abortion.
IV, IM: Postpartum control of bleeding after expulsion of the placenta.
Complications: Maternal adverse reactions are noted for IV use only.
● CNS:
● maternal—COMA, SEIZURES;
● fetal, INTRACRANIAL HEMORRHAGE.
● Resp:
● fetal—ASPHYXIA, hypoxia.
● CV:
● maternal— hypotension;
● fetal, arrhythmias.
● F and E:
● maternal— hypochloremia, hyponatremia, water intoxication.
● Misc:
● Maternal— ↑ uterine motility, painful contractions, abruptio placentae, ↓
uterine blood flow, hypersensitivity.Medication Administration:
● Induction/Stimulation of Labor IV (Adults): 0.5– 1 milliunits/min; ↑ by 1– 2 milliunits/min q 30–
60 min until desired contraction pattern established; dose may be ↓ after desired frequency of
contractions has been reached and labor has progressed to 5-6 cm dilation.
● Postpartum Hemorrhage IV (Adults): 10 units infused at 20– 40 milliunits/min. IM (Adults): 10
units after delivery of placenta.
● Incomplete/Inevitable Abortion IV (Adults): 10 units at a rate of 20– 40 milliunits/min.
Contraindications/Precautions:
Contraindicated in: Hypersensitivity; Anticipated nonvaginal delivery.
Use Cautiously in: OB:First and second stages of labor; slow infusion over 24 hr has caused
water intoxication with seizure and coma or maternal death due to oxytocin’s antidiuretic effect.
Nursing Interventions:
Assessment:
● Fetal maturity, presentation, and pelvic adequacy should be assessed prior to
administration of oxytocin for induction of labor.
● Assess character, frequency, and duration of uterine contractions; resting uterine tone;
and fetal heart rate frequently throughout administration. If contractions occur 2 min
apart and are 50– 65 mm Hg on monitor, if they last 60– 90 sec or longer, or if a
significant change in fetal heart rate develops, stop infusion and turn patient on her left
side to prevent fetal anoxia. Notify health care professional immediately.
● Monitor maternal BP and pulse frequently and fetal heart rate continuously throughout
administration.
● This drug occasionally causes water intoxication. Monitor patient for signs and
symptoms (drowsiness, listlessness, confusion, headache, anuria) and notify physician
or other health care professional if they occur.
● Lab Test Considerations: Monitor maternal electrolytes. Water retention may result
in
hypochloremia or hyponatremia.
Implementation:
● Do not administer oxytocin simultaneously by more than one route. IV Administration
● Continuous Infusion: Rotate infusion container to ensure thorough mixing. Store
solution in refrigerator, but do not freeze.
● Infuse via infusion pump for accurate dose. Oxytocin should be connected via Y Site
injection to an IV of 0.9% NaCl for use during adverse reactions.
● Magnesium sulfate should be available if needed for relaxation of myometrium.● Induction of Labor: Diluent: Dilute 1 mL (10 units) in 1 L of compatible infusion fluid
(0.9% NaCl, D5W, or LR). Concentration: 10 milliunits/mL. Rate: Begin infusion at 0.5– 2
milliunits/min (0.05– 0.2 mL); increase in increments of 1– 2 milliunits/min at 15– 30-min
intervals until contractions simulate normal labor.
● Postpartum Bleeding: Diluent:For control of postpartum bleeding, dilute 1– 4 mL (10–
40 units) in 1 L of compatible infusion fluid. Concentration: 10– 40 milliunits/mL. Rate:
Begin infusion at a rate of 20– 40 milliunits/min to control uterine atony. Adjust rate PRN.
● Incomplete or Inevitable Abortion:
● Diluent: For incomplete or inevitable abortion, dilute 1 mL (10 U) in 500 mL of
0.9% NaCl or D5W.
● Concentration: 20 milliunits/mL.
● Rate: Infuse at a rate of 20– 40 milliunits/min.
Interactions:
Drug-Drug: Severe hypertension may occur if oxytocin follows administration of vasopressors.
Client Education:
● Advise patient to expect contractions similar to menstrual cramps after administration has
started.
Evaluation of Medication Effectiveness:
● Onset of effective contractions.
● Increase in uterine tone.
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