AHRQ Safety Program for Perinatal Care Purpose of the tool: This tool describes the key perinatal safety elements with examples for the safe administration of oxytocin during labor. The key elements are presented within the framework of the Comprehensive Unit-based Safety Program (CUSP). Who
should use this tool: Nurses, physicians, midwives, pharmacists, and other labor and delivery (L&D) unit staff involved in the preparation and administration of oxytocin during labor. How to use this tool: Review the key perinatal safety elements with L&D leadership and unit staff to determine how elements will be implemented on your L&D unit. Consider any existing facility policies or processes related to oxytocin use. Consider using preprinted orders, standing
orders, and staff training to support implementation. A sample of how some of these key perinatal safety elements can be incorporated into a unit approach to safe oxytocin administration is provided in the Appendix of this tool. A sample process and forms for a committee review are available at the Council on Patient Safety in Women’s Health Care, www.safehealthcareforeverywoman.org. In the context of oxytocin use, this includes staff alertness for early signs of fetal or maternal distress, and knowing the plan for a timely response to prevent
further deterioration. Every effort was made to ensure the accuracy and completeness of this resource. However, the U.S. Department of Health and Human Services makes no warranties regarding errors or omissions and
assumes no responsibility or liability for loss or damage resulting from the use of information contained within. Examples of gestational dating documentation include the following: Standing Orders for Response to Complications: For tachysystole, the following should be implemented as standing physician orders so that nurses can implement without delay: For Category I FHR pattern and tachysystole: Note: Consider any fluid restrictions the patient may have. If uterine activity does not return to normal after 10 minutes, decrease the oxytocin rate by at least half; if uterine activity has not returned to normal after 10 more minutes, discontinue the oxytocin until uterine activity is less than five contractions in 10 minutes. For Category II and III FHR and tachysystole: Note: Consider any fluid restrictions the patient may have. If no response, administer terbutaline 0.25 mg SC. Discontinue oxytocin infusion and notify provider for— For decreased urine output or maternal hypotension, administer 500 cc of LR by IV bolus, and notify provider of response to bolus. Resumption of oxytocin after discontinuation:
[Note: some facilities choose to require a provider order to restart oxytocin] If oxytocin has been discontinued for less than 30 minutes— Note: Do not start oxytocin on patients who are < 4 hours post-insertion of misoprostol. Note: Do not start oxytocin on patients who are < 4 hours post-insertion of misoprostol. Page last reviewed May 2017 Page originally created April 2017 Internet Citation: Safe Medication Administration: Oxytocin. Content last reviewed May 2017. Agency for Healthcare Research and Quality, Rockville, MD. What happens during the first stage of labor Pearson?The first stage starts when labor begins and ends with full cervical dilation and effacement. The second stage commences with complete cervical dilation and ends with the delivery of the fetus. The third stage initiates after the fetus is delivered and ends when the placenta is delivered.
Which factors are included in patient evaluation when considering induction of labor using the Bishop score quizlet?Which factors are included in patient evaluation when considering induction of labor using the Bishop score? High fetal stations are not favorable for induction of labor according to the Bishop score. Cervical effacement is an important consideration in the Bishop score.
In which situation is there an increased likelihood for prolonged labor quizlet?In which situation is there an increased likelihood for prolonged labor? b. The woman is nulliparous.
What approach would a nurse take to best assess the progress of a woman in labor quizlet?What approach would be best for the nurse to use when assessing for ruptured membranes in a laboring client? Test the vaginal fluid with nitrazine paper. Which factor places a client at risk for a prolapsed cord?
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