Induction/Augmentation
What do you need to do to start pit?
Cervical check
Talk to provider
2 RN checks for start of Pit
When do you increase pit?
every 30min
as long as uterine activity allows
and FHR is reassuring
At around what SVE (cm) can you start pit?
2cm or 1 and thin
What top items are needed for preparation of delivery?
Table set up for vaginal delivery
Medtronic scanner
Pit bag
Warmer to be set up
baby papers
At what rate do you start the first and second bag of pit?
1st- 999
2nd- 41.7
What do you when pt is tachysystole and/or having decels?
Fluid bolus
change position
half pit
stop pit
What is standard order that pitocin can go up to?
20
What must the nurse do when wanting to go over 20 of pit?
Insert IUPC
Inform the doctor for new order
What port does pit need to be put on when a patient is on magnesium, pitocin and LR?
1st!
How long does the second bag of pitocin run for (hours)?
4 hours
What are RN responsibilities of Pit?
Decrease dosage rate when contraction are too frequent
Decrease rate if indeterminate or abnormal FHR pattern occurs
Increase dosage when uterine activity and labor process is inadequate
What can you do for intrauterine resuscitation?
Promote Fetal Oxygenation
Reduce uterine activity
Alleviate umbilical cord compression
Correct hypotension
Patient delivered and is hemorrhaging and their IV came out and patient is a hard stick. What do you anticipate happening?
IM pit
What MVU are inadequate for increasing pit?
300+
When do you start pit after delivery?
When the doctor says or when the placenta comes out
Why would you administer Pit?
FHR or rhythm abnormality
Your multipara pt came in and was closed/10/-3 after four hours the pt is 2/50/-3. What would you recommend to the doctor in the SBAR.
Starting pitocin :)
What is a risk of oxytocin in labor?
Uterine Rupture (especially in scarred uterus)
How many variables are you able to have in the last 30 minutes and still be able to increase pitocin?
2 as long as they are less than 60 seconds in and decreasing less than 60bpm
Besides Pitocin in the PPH order what other medications can be given?
Methergine
Hemobate
Cytotec
TXA
What are the two medications compatible with pitocin?
What can help a boggy uterus in a c-section?
IM pit usually given by CRNA
At what time do you have to notify MD after stopping pit?
30mins
When would you administer TXA in PPH?
After the bolus pit is done
How many hours is considered prolonged use of pitocin?
more than 12 hours