Final answer:
Janine is at highest risk for developing hypotonic contractions due to her prolonged labor and minimal cervical dilation, leading to frequent nursing assessments and the start of a pitocin IV infusion to promote labor progression.
Step-by-step explanation:
The woman at highest risk for developing hypotonic contractions would likely be Janine, who is 41 weeks pregnant with her first child and has been experiencing prolonged labor that is not progressing effectively. Because her cervix is only dilated to 2 cm despite the feeling of being in labor for days, and the amniotic sac is intact, she is at risk of having hypotonic contractions, which are not effectively dilating the cervix. This can lead to labor dystocia, necessitating frequent nursing assessments and possible medical intervention to ensure the health and safety of both the mother and the fetus.
An IV infusion of pitocin is started to stimulate stronger contractions and progress labor. Pitocin is a synthetic form of oxytocin, the hormone that naturally increases in the body to promote uterine contractions. Its administration is common when labor is not progressing because it can enhance uterine contractility, helping to move the labor process forward. These stronger contractions should help to increase cervical dilation, leading toward a successful delivery.