Heather Shane, a 26 y.o. G1P0, presents to the labor unit for elective induction of labor at 39 weeks gestation. She has with her the following admission orders:
Admit to labor unit for elective IOL
LR at 125 mL/hr after initial bolus of 500 mL
SVE q 2 hrs
O2 via facemask at nurse discretion
Cytotec 25.0 mcg buccal q 4 hrs
Pitocin 2 mg/min after 4cm dilated max 30 mu/min
Regular diet until active labor
PCN 5 million units initial dose and 2.5 million units q 4 hrs until delivery IV
Cont. EFM
IUPC/FSE as needed per RN
Call with VS out of range
Methergine 0.2 mg IM PRN bleeding
Carboprost 250 mcg IV PRN bleeding
Pitocin 20 units IV bolus at delivery of placenta
Upon placing Mrs. Shane on the monitor you note FHR in the 130’s with good variability and occasional variable decels. She reports a history that includes gestational hypertension that she takes medication for. She denies being able to recall name of medication, but knows that it is 200 mg by mouth once in the morning and evening. She states that it is blue in color. She also states that when she came in at approximately 30 weeks due to the increase in her blood pressure they gave her a shot of a medication for the baby’s lungs and that she was noted to be having mild contractions at that time. They also gave her medication for the contractions that was called procardiac. She stopped taking that medication at 36 weeks.
- List any and all items noted to need correction or clarification in the order set.
- What medication is Mrs. Shane most likely taking for her blood pressure?
- What medication was she given “for the baby’s lungs” at 30 weeks?
- What is the proper name for “procardiac” and why is it being used for preterm labor contractions?
- Which medications have pregnancy risks associated with them? What is the concern?
- What nursing considerations should the nurse account for with a patient receiving Oxytocic drugs?
- Which medication is not indicated for use in the hypertensive patient?