Health Promotion and Maintenance
75. A client, who is a gravida 3, para 1, presents to labor and delivery at 41 4/7 weeks' gestation for induction of labor. Her cervix is 2 cm dilated, 80% effaced, and a –3 station. A nurse anticipates that, in preparation for labor, a physician will likely order: Select all that apply.
. Hemabate 250 mcg IM.
. Pitocin at 2 milliunits/min IV.
. Betamethasone 6 mg IM.
. Cytotec 200 mcg PO.
. Cervidil 10 mg vaginally.
Test-Taking Tip
Focus on the agents used to induce labor (Answers 2 and 5). Eliminate those medications that are used in postpartum hemorrhage and preterm labor (Answers 1 and 3) but are not used to induce labor.
Content Area: Maternity, Intrapartum; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
Health Promotion and Maintenance
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Answer 1 is incorrect because Hemabate is used to control postpartum hemorrhage, and is contraindicated for induction of labor. Answer 2 is correct because pitocin at 2 milliunits/min IV is an appropriate dose for induction of labor in a client who is past her estimated date of delivery. Answer 3 is incorrect because betamethasone is used to stimulate fetal lung maturity in preterm gestation, and is not used for induction of labor. Answer 4 is incorrect because Cytotec is used for induction of labor, but 200 mcg is too high a dose for induction of labor and may cause uterine hyperstimulation and uterine rupture. The normal dose of Cytotec for induction is 25 mcg vaginally or 50 mcg orally. Answer 5 is correct because cervidil 10 mg vaginally is an appropriate method to induce labor.