Oxytocin (Pitocin)

CLASSIFICATION

Uterine smooth muscle stimulant

ACTIONS

Contracts uterine and mammary smooth muscle. Increases force, frequency, and duration of uterine contractions.

USES

• Managing incomplete or inevitable abortion

• Controlling postpartum hemorrhage

• Inducing term labor

CONTRAINDICATIONS

• Cephalopelvic disproportion, previous uterine surgery

• Unengaged fetal head, unfavorable fetal position or presentation

• Fetal distress without evidence of imminent delivery

• Placenta previa or cord prolapse or both

• Women with active genital herpes

PRECAUTIONS

• Used with great caution in women who are high parity (5 or more)

SIDE EFFECTS

• Tachycardia, premature ventricular contraction, hypotension

• Nausea, vomiting, water intoxication

NURSING IMPLICATIONS

1. ^*Frequently assess baseline vital signs, blood pressure, and fetal heart rate.^*

2. ^*Constantly monitor frequency, duration, and strength of contractions.^*

3. ^*Stop the infusion; notify the physician if the resting uterine pressure is above 15 to 20 mm Hg, if contractions are lasting longer than 1 minute, if they are occurring more frequently than every 2 to 3 minutes, or if an alteration in fetal heart rhythm or rate occurs.^*

4. Maintain input and output; evaluate for excessive water retention.

5. Do not confuse with vasopressin (Pitressin), which is an antidiuretic hormone.

Rh_o(D) Immune Globulin (RhIG) (RhoGAM)

CLASSIFICATION

Immunosuppressant

ACTION

Rh_o(D) immune globulin (RhIG) is an immunoglobulin that is a concentrated preparation that contains antibodies to Rh_o(D). This prevents an Rh-negative woman from developing antibodies after exposure to Rh_o(D)-positive blood.

USES

• Prevents sensitization in Rh-negative pregnant patient given in the last trimester of pregnancy, as well as after abortion or miscarriage.

CONTRAINDICATIONS

• Not given to Rh-positive women.

• Newborn

SIDE EFFECTS

• Uncommon and mild effects

• Slight temperature elevation

NURSING IMPLICATIONS

1. ^*Administered intramuscularly at 28 weeks’ gestation and again within 72 hours after delive^*ry.

2. ^*May also be administered to Rh-negative women receiving a blood transfusion or who have had a spontaneous or induced abortion or amniocentesis.^*

3. ^‡Instruct Rh-negative patients to advise health care providers of their Rh-negative status.^‡

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