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Oxytocin Administration: The Transition to a Safer Model of Care

The Journal of Perinatal & Neonatal Nursing: January/March 2012 - Volume 26 - Issue 1 - p 25–26
doi: 10.1097/JPN.0b013e318248b1ba
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Back to Top | Article Outline


General Purpose: To provide registered professional nurses with an understanding of a low-dose oxytocin administration protocol and management of associated outcomes.

Learning Objectives: After reading this article and taking this test, you should be able to:

  1. Describe the pharmacokinetics of and potential adverse effects from oxytocin administration.
  2. Outline a low-dose oxytocin protocol and the management of adverse effects from the drug.
  1. One of the leading causes of obstetrical liability claims involves oxytocin-caused
    1. postpartum hemorrhage.
    2. hypertensive episodes.
    3. tachysystole.
    4. pelvic hematoma.
  2. With high-alert medications, the most common type of adverse event that occurs is related to
    1. administration.
    2. dispensing.
    3. ordering.
    4. preparation.
  3. What is the half-life of oxytocin?
    1. 2 to 3 minutes
    2. 4 to 6 minutes
    3. 10 to 12 minutes
    4. 14 to 16 minutes
  4. How many half-lives are required to achieve steady state concentration of oxytocin?
    1. 1 to 2
    2. 3 to 5
    3. 6 to 8
    4. 9 to 10
  5. Uterine response would be notable how long after the steady state of oxytocin is achieved?
    1. 5 to 10 minutes
    2. 15 to 20 minutes
    3. 30 to 60 minutes
    4. 80 to 90 minutes
  6. As noted by Simpson and James (2008), persistent increased uterine activity causes
    1. Category I fetal heart rate tracings.
    2. a decrease in umbilical artery PCO2 levels.
    3. fetal alkalemia.
    4. a steady decline in fetal oxygen saturation.
  7. In the protocol described in this article, prerequisites for oxytocin administration include all of the following except
    1. terbutaline readily available.
    2. verification of funis presentation.
    3. an available labor and delivery nurse.
    4. a physician with cesarean section privileges readily available.
  8. Which mixture of oxytocin creates a concentration of 1 milliunit (mU) oxytocin equaling 1 mL/h?
    1. 10 units of oxytocin/250 mL of intravenous (IV) fluid
    2. 20 units of oxytocin/500 mL of IV fluid
    3. 30 units of oxytocin/500 mL of IV fluid
    4. 40 units of oxytocin/1000 mL of IV fluid
  9. According to the protocol, incremental doses of 1 to 2 mU/min can be given every
    1. 5 to 10 minutes.
    2. 12 to 15 minutes.
    3. 20 to 25 minutes.
    4. 30 to 60 minutes.
  10. The maximum oxytocin dose in the protocol without bedside assessment and an additional order by the provider is
    1. 20 mU/min.
    2. 30 mU/min.
    3. 40 mU/min.
    4. 50 mU/min.
  11. What is the goal for the number of moderate to strong contractions per palpation in a 10-min period?
    1. 1 to 2
    2. 3 to 4
    3. 5 to 6
    4. 7 to 8
  12. Treatment of uterine tachysystole in active labor with a Category I fetal heart rate includes
    1. discontinuing oxytocin.
    2. performing intrauterine resuscitation measures.
    3. decreasing the oxytocin rate.
    4. reevaluating in 15 minutes.
  13. Patients who have had extended administration of oxytocin should be monitored for signs of water intoxication including
    1. seizures.
    2. hypertension.
    3. insomnia.
    4. bradycardia.
  14. Signs and symptoms of impending or actual uterine rupture include all of the following except
    1. sudden cessation of pain.
    2. abdominal rigidity.
    3. loss of station.
    4. suprapubic pain.
  15. Which of the following is included in the patient education handout regarding oxytocin?
    1. the low-dose protocol
    2. infusion duration
    3. treatment of potential adverse effects
    4. possible alternatives
  16. Compared to the time before the oxytocin protocol, the average length of labor postprotocol implementation was
    1. 1/2
    2. 1 hour less.
    3. 11/2
    4. 2 hours less.
  17. The overall incidence of tachysystole postimplementation compared with preimplementation was reduced by almost
    1. 9%.
    2. 17%.
    3. 21%.
    4. 33%.
  18. Between preimplementation in 2008 and postimplementation in 2010, the primary cesarean section rate dropped by almost
    1. 4%.
    2. 5%.
    3. 6%.
    4. 7%.


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