NSG 3500 - Maternal Exam 2
Indications for Induction
1. Post term pregnancy
2. Gestational HTN
3. Fetal demise
4. PROM
5. Preeclampsia/Eclampsia
6. IUGR
T or F: Oxytocin is a Cervical Ripening Agent
False, cervical ripening agents are used when oxytocin is not favorable; however, oxytocin may
be used after cervical ripening has occurred to induce labor
What are the 2 most common cervical ripening agents?
1. Prostaglandin E1 (Misoprostol/Cytotek)
2. Prostaglandin E2 (Dinoprostone/Cervidil/Prepidil)
What are the mechanical methods of cervical ripening?
1. Balloon catheter
2. Hydroscopic dilators
3. Amniotomy
What is Cervidil?
, Small plastic insert containing prostaglandin with long string is placed into the posterior fornix
of the vagina
How long does cervidil remain in the vagina?
12 Hours
What precautions must a patient receiving cervidil follow?
1. Stay in bed for first 2 hours (supine or side lying)
2. May get up only for bathroom
3. Stay on monitor
What do you do if tachysystole/hypersystole occurs in a patient receiving cervidil?
Remove the insert by wrapping fingers in saline soaked gauze and pull then administer
terbutaline
How can you use a foley to cause mechanical cervical ripening?
Insert the catheter into the intracervical canal to increase pressure on lower uterine segment
T or F: A transcatheter has the highest risk of causing tachysystole?
False, it is associated with the lowest risk
What is the maximum dose of oxytocin?
20 mU/min
Which IV hub should oxytocin be ran through? (Location)
Closest to patient in case of reaction
What are some contraindications to oxytocin?
1. Placenta previa
2. Transverse fetal lie
3. Umbilical cord prolapse
4. Previous c-section
5. Multifetal pregnancy
6. HTN
What are the methods for the augmentation of labor?
Indications for Induction
1. Post term pregnancy
2. Gestational HTN
3. Fetal demise
4. PROM
5. Preeclampsia/Eclampsia
6. IUGR
T or F: Oxytocin is a Cervical Ripening Agent
False, cervical ripening agents are used when oxytocin is not favorable; however, oxytocin may
be used after cervical ripening has occurred to induce labor
What are the 2 most common cervical ripening agents?
1. Prostaglandin E1 (Misoprostol/Cytotek)
2. Prostaglandin E2 (Dinoprostone/Cervidil/Prepidil)
What are the mechanical methods of cervical ripening?
1. Balloon catheter
2. Hydroscopic dilators
3. Amniotomy
What is Cervidil?
, Small plastic insert containing prostaglandin with long string is placed into the posterior fornix
of the vagina
How long does cervidil remain in the vagina?
12 Hours
What precautions must a patient receiving cervidil follow?
1. Stay in bed for first 2 hours (supine or side lying)
2. May get up only for bathroom
3. Stay on monitor
What do you do if tachysystole/hypersystole occurs in a patient receiving cervidil?
Remove the insert by wrapping fingers in saline soaked gauze and pull then administer
terbutaline
How can you use a foley to cause mechanical cervical ripening?
Insert the catheter into the intracervical canal to increase pressure on lower uterine segment
T or F: A transcatheter has the highest risk of causing tachysystole?
False, it is associated with the lowest risk
What is the maximum dose of oxytocin?
20 mU/min
Which IV hub should oxytocin be ran through? (Location)
Closest to patient in case of reaction
What are some contraindications to oxytocin?
1. Placenta previa
2. Transverse fetal lie
3. Umbilical cord prolapse
4. Previous c-section
5. Multifetal pregnancy
6. HTN
What are the methods for the augmentation of labor?
