A client is receiving (Pitocin) oxytocin to induce labor. The nurse should monitor for which of the following adverse maternal effects?

Jaundice

Dehydration

Uterine hyperstimulation.

Maternal bradycardia

Answer and Explanation

The Correct Answer is C

A. Jaundice. Oxytocin does not cause jaundice in the mother. Jaundice is typically related to liver dysfunction, hemolysis, or bile obstruction and is not an expected side effect of oxytocin administration.

B. Dehydration. While prolonged labor induction may contribute to dehydration if fluid intake is insufficient, oxytocin itself does not directly cause dehydration. IV fluids are typically administered alongside oxytocin to maintain hydration during labor.

C. Uterine hyperstimulation. Uterine hyperstimulation (tachysystole), defined as more than five contractions in 10 minutes, is a serious complication of oxytocin administration. It can lead to fetal distress, uterine rupture, and impaired placental perfusion. If hyperstimulation occurs, the nurse should discontinue oxytocin, reposition the patient, provide oxygen, and notify the provider.

D. Maternal bradycardia. Oxytocin does not typically cause bradycardia. Maternal side effects are more commonly tachycardia, hypertension, or fluid retention. Fetal bradycardia, however, can occur if uterine hyperstimulation leads to fetal hypoxia.

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Correct Answer is B

Explanation

A. Oligohydramnios. Oligohydramnios, or low amniotic fluid levels, is not a primary complication of pregestational diabetes. It is more commonly associated with conditions such as fetal growth restriction, post-term pregnancy, and rupture of membranes rather than maternal hyperglycemia.

B. Congenital fetal anomalies. Poor glycemic control during preconception and early pregnancy increases the risk of congenital anomalies, particularly affecting the heart, spine, and central nervous system. Hyperglycemia during organogenesis (first 8 weeks of gestation) can lead to defects such as neural tube defects and cardiac malformations.

C. Intrauterine fetal seizures. Fetal seizures in utero are extremely rare and are not a common complication of maternal diabetes. While neonatal hypoglycemia after birth can lead to seizures, maternal hyperglycemia does not directly cause seizures in the fetus.

D. Polyhydramnios. While polyhydramnios (excess amniotic fluid) can occur in pregnancies complicated by diabetes due to fetal polyuria, it is more associated with later pregnancy. The question specifically asks about preconception and early pregnancy risks, making congenital anomalies the best answer.

A. Uterine prolapse. B. Uterine rupture. C. Precipitous labor. D. Amniotic fluid embolus.

Correct Answer is B

Explanation

A. Uterine prolapse. Uterine prolapse occurs when the uterus descends into or outside the vagina, usually postpartum due to weakened pelvic support. It does not present with sudden, severe pain or fetal heart rate abnormalities during labor.

B. Uterine rupture. A tearing sensation, sudden severe pain, fetal heart rate abnormalities, pallor, and diaphoresis are hallmark signs of uterine rupture. This is a life-threatening emergency where the uterine wall tears, often due to prior cesarean scars, excessive oxytocin use, or grand multiparity. Immediate intervention, including emergency surgery, is required to prevent maternal and fetal death.

C. Precipitous labor. Precipitous labor is rapid labor and delivery within three hours and is not associated with severe, tearing pain. While it can cause fetal distress, it does not typically involve uterine rupture symptoms.

D. Amniotic fluid embolus. An amniotic fluid embolus presents with sudden respiratory distress, hypotension, and cardiovascular collapse due to amniotic fluid entering the maternal circulation. It does not typically cause localized severe abdominal pain or fetal distress due to uterine rupture.

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A client is receiving (Pitocin) oxytocin to induce labor. The nurse should monitor for which of the following adverse maternal effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Preconception counseling is critical to the outcome of a pregnancy for a patient with diabetes because poor glycemic control before and during early pregnancy is associated with:

Correct Answer is B

Explanation

During augmentation of labor with intravenous oxytocin (Pitocin), a multiparous client becomes pale and diaphoretic and complains of severe lower abdominal pain with a tearing sensation. An abnormal FHR tracing is noted on the monitor. The nurse should suspect:

Correct Answer is B

Explanation

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