On the labor and delivery floor, during my preceptorship, many patients were induced by a medication called Dinoprostone. If the patients were being induced they would come in the night before and be admitted. At this time the nurses orient the patient and family to their room, complete the labor and delivery admission record, hook the patient up to the fetal monitors, and perform an assessment that includes maternal vital signs, heart and lung sounds, deep tendon reflexes, and signs of edema. After the patient is settled into their room and before shift change the nurse goes and inserts Dinoprostone to start uterine contractions. Dinoprostone vaginal insert, commonly known as Cervidil, is used to ripen the cervix at or near term when induction
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One of the effects of oxytocin is uterine contractions. According to the Journal of Midwifery and Women’s Health, a standard oxytocin protocol has numerous benefits including a decreased risk of oxytocin-induced tachysystole, fetal hypoxemia, maternal pain, placental abruption, uterine rupture, unnecessary cesarean birth for indeterminate/abnormal fetal heart rate patterns, and postpartum hemorrhage and infection. According to the protocol, Pitocin is started at 2mU/minute and increased by 2mU/minute; no more frequently than every thirty minutes based on the maternal and fetal response. The nurse should be monitoring the patient for the most common side effect of Pitocin which is excessive uterine activity. Tachysystole is when there are five contractions in ten minutes averaged over thirty minutes, and can have a progressive negative effect on fetal oxygenation and should be avoided (Simpson, …show more content…
The fetal heart rate and contractions are interpreted and charted every fifteen to thirty minutes. According to Durham and Chapman maternal-newborn nursing, there are three major areas assessed when interpreting fetal heart rate patterns which include: FHR baseline, periodic and episodic changes, and uterine activity. Interpretation of the FHR baseline includes: baseline rate and baseline variability, periodic and episodic changes includes: accelerations and decelerations, and interpretation of uterine activity includes: frequency, duration, intensity, resting tone, and relaxation time between uterine contractions (Durham, Chapman, 2014). When looking at a ten-minute window the baseline FHR is rounded to increments of five beats per minute excluding accelerations, decelerations, or marked variability. The normal range is between 110 to 160 beats per minute with a baseline above 160 indicating tachycardia and a baseline below 110 indicating bradycardia. Baseline variability refers to the fluctuations in the baseline FHR that are irregular in amplitude and frequency. The variability can be described as absent, minimal, moderate or marked. Periodic changes are accelerations and decelerations in the FHR that are in relation to uterine contractions. These include accelerations and four types of decelerations: early, variable, late, and prolonged. Episodic changes
One of the effects of oxytocin is uterine contractions. According to the Journal of Midwifery and Women’s Health, a standard oxytocin protocol has numerous benefits including a decreased risk of oxytocin-induced tachysystole, fetal hypoxemia, maternal pain, placental abruption, uterine rupture, unnecessary cesarean birth for indeterminate/abnormal fetal heart rate patterns, and postpartum hemorrhage and infection. According to the protocol, Pitocin is started at 2mU/minute and increased by 2mU/minute; no more frequently than every thirty minutes based on the maternal and fetal response. The nurse should be monitoring the patient for the most common side effect of Pitocin which is excessive uterine activity. Tachysystole is when there are five contractions in ten minutes averaged over thirty minutes, and can have a progressive negative effect on fetal oxygenation and should be avoided (Simpson, …show more content…
The fetal heart rate and contractions are interpreted and charted every fifteen to thirty minutes. According to Durham and Chapman maternal-newborn nursing, there are three major areas assessed when interpreting fetal heart rate patterns which include: FHR baseline, periodic and episodic changes, and uterine activity. Interpretation of the FHR baseline includes: baseline rate and baseline variability, periodic and episodic changes includes: accelerations and decelerations, and interpretation of uterine activity includes: frequency, duration, intensity, resting tone, and relaxation time between uterine contractions (Durham, Chapman, 2014). When looking at a ten-minute window the baseline FHR is rounded to increments of five beats per minute excluding accelerations, decelerations, or marked variability. The normal range is between 110 to 160 beats per minute with a baseline above 160 indicating tachycardia and a baseline below 110 indicating bradycardia. Baseline variability refers to the fluctuations in the baseline FHR that are irregular in amplitude and frequency. The variability can be described as absent, minimal, moderate or marked. Periodic changes are accelerations and decelerations in the FHR that are in relation to uterine contractions. These include accelerations and four types of decelerations: early, variable, late, and prolonged. Episodic changes