Question

A client whose labor is being augmented with an oxytocin (Pitocin) infusion requests an epidural for pain control. Findings of the last vaginal exam, performed 1 hour ago, were 3 cm cervical dilatation, 60

1) Decrease the oxytocin infusion rate
2) Determine current cervical dilation
3) Request placement of the epidural
4) Give a bolus of intravenous fluids

Answer 1

In response to a laboring client's request for an epidural, current cervical dilation should be determined first, followed by the placement of the epidural for pain control, and provision of a bolus of intravenous fluids. Adjusting the oxytocin infusion may be considered after these steps.

Step-by-step explanation:

The subject of the question relates to the management of labor with the administration of oxytocin (Pitocin) and the potential requirement for an epidural for pain relief. A client whose labor is being augmented with oxytocin infusion requests an epidural for pain control. The sequential steps that should likely be taken in response to this request include the following:

1. Determine the current cervical dilation, as it is important to evaluate if labor is progressing and also to check if there are any contraindications to epidural placement.
2. Request the placement of the epidural for pain control after the current state of dilation is evaluated.
3. Typically, a bolus of intravenous fluids is given prior to the placement of the epidural to prevent hypotension.
4. Adjusting the oxytocin infusion rate may be necessary depending on the labor progress and in consultation with the healthcare provider, but evaluating dilation and managing pain take precedence.