1. Which of the following is a contraindication for use of oxytocin to induce labor?
A. Missed abortion
B. Placenta previa
C. Hyperbilirubinemia
D. Pregnancy past due date
Answer: B. Placenta previa
Use of oxytocin is contraindicated in the presence of placenta previa. Laborinduction in this condition
could be fatal to the fetus. Placenta previa is an indication for cesarean section. Specific
contraindicationsto oxytocin include hypersensitivity to the hormone itself or any part of itssynthetic
version and vaginal deliveries that are in themselves contraindicated. These include the patient having
an active genital herpes infection, vasa previa, complete placenta previa, invasive cervical cancer, and
prolapse or presentation of the umbilical cord).
Option A: Oxytocin is indicated and approved by the FDA for two specific time frames in the
obstetric world: antepartum and postpartum. In the antepartum period, exogenous oxytocin is
FDA-approved forstrengthening uterine contractions with the aim ofsuccessful vaginal delivery
of the fetus. There are three situations during the antepartum period in which oxytocin is
indicated for mothers who have preeclampsia, maternal diabetes, premature rupture of the
membranes; for mothers with inactive uteri that require stimulation to start labor; and for
mothers with inevitable or incomplete abortions in their second trimester.
Option C: Hypoosmolarity causes swelling of the red blood cells and makes them fragile and
susceptible to hemolysis. Various studies have approved the effects of oxytocin on jaundice.
Some studies have suggested that the extensive use of oxytocin in labor induction is one of the
factorsleading to neonatal jaundice
Option D: When oxytocin is released, it stimulates uterine contractions, and these uterine
contractions, in turn, cause more oxytocin to be released; this is what causes the increase in
both the intensity and frequency of contractions and enables a mother to carry out vaginal
delivery completely. The head of the fetus pushes against the cervix,the nerve impulsesfrom
this action travel to the mother’s brain, which activates the posterior pituitary to secrete
oxytocin. This oxytocin is then carried through the blood to the uterus to increase uterine
contractions further, and the cycle continues until parturition.
2. Which of the following insulin cannot be mixed with any other type of insulin?
A. Insulin glargine
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