Question

The nurse is monitoring a client in labor who is receiving oxytocin and notes that the client is experiencing hypertonic uterine contractions. In order of priority, how should the nurse plan the actions to take? Arrange the actions in the order that they should be performed. All options must be used.

Select the correct sequence number for each item.

		1	2	3	4	5	6
1.	Reposition the client.	1	2	3	4	5	6
2.	Stop the oxytocin infusion.	1	2	3	4	5	6
3.	Perform a vaginal examination.	1	2	3	4	5	6
4.	Check the client's blood pressure.	1	2	3	4	5	6
5.	Administer oxygen by face mask at 8 to 10 L/min.	1	2	3	4	5	6
6.	Administer medication as prescribed to reduce uterine activity.	1	2	3	4	5

Answer 1

Hypertonic uterine contraction is the hyperstimulation of the uterus while inducing labor through use of oxytocin. This results in increased uterine contraction of longer duration. The complications includes uterine prolapse, fetal abnormalities and disruption of the placenta.
When the patient suffers from hypertonic uterine contraction following interventions are used in priority order:

- stop oxytocin infusion to avoid hyperstimulation of uterus and administer medicines that will reduce uterine activity.
- check client's blood pressure for hypertension or hypotension.
- assess the cause of hypertonic uterine contraction and perform vaginal examination to check for prolapsed uterus or cord.
- position the patient in side lying and start administering oxygen through face mask.

So the sequence of events is 2,6,4,3,5,1