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Unformatted text preview: SCANNED TO PHARMACY
Date: ________________ Time: _____________
3. 4. Admit to Labor and Delivery for Induction of Labor at ______ weeks gestation
Routine Labor and Delivery Admission Orders
Indication for Induction (check one)
Postdates – EDC: _______________________
Preeclampsia: Mild Severe
Fetal Indication: ________________________
Complete Pre-Induction Checklist AUGMENTATION
9. 10. 11.
12. 13. 14. 15. 16. Augment Labor with Oxytocin. Complete Pre-Augmentation Checklist.
Indication for Augmentation: _____________________________________________________________
Monitor FHR and Uterine contractions per Oxytocin / Augmentation of Labor Protocol
IV Oxytocin Concentration: 15 units in 250 mL Lactated Ringers solution – Note: 1 milliUnit = 1 mL/hour
Start Oxytocin Infusion at 1 milliUnit / minute
Increase Oxytocin Infusion Rate by:
1 milliUnit / minute
2 milliUnit / minute (May increase by only 1 milliUnit if 4 contractions in 10 minutes and/or when
contractions are lasting greater than 90 seconds).
Frequency of increase in Oxytocin infusion rate:
Every 30 minutes, until contractions are consistently 2-3 minutes apart and painful and/or there is
evidence of cervical change. Increase only if all the In-Use Checklist criteria met.
Notify MD when Oxytocin infusion rate reaches 20 milliUnits / minute
Initiate intra-uterine resuscitation measures as indicated for FHR pattern, which may include:
Give oxygen by non-rebreather mask at 10 L/min.
Increase primary IV to bolus rate 500 mL over 10 minutes x 1
Contact physician for further IV bolus orders
When the In-Use Checklist FHR criteria NOT MET, and the Uterine criteria MET:
Decrease infusion rate of Oxytocin by 2 milliUnits/min or more, and initiate intrauterine resuscitation measures.
Notify physician if interventions not effective.
When the In-Use Checklist Uterine criteria NOT MET, and the FHR criteria MET:
Decrease infusion rate of Oxytocin by 2 milliUnits/min Q 10 minutes, or more frequently, until tachysystole
or prolonged contractions have resolved.
May resume increasing the Oxytocin infusion rate, as ordered above, when In-Use Checklist Criteria have
Consult physician for plan of care if the Oxytocin dose has been decreased two (2) consecutive times prior to
resuming increase of Oxytocin
When both the In-Use Checklist FHR criteria and Uterine criteria NOT MET:
Initiate intra-uterine resuscitation measures
If Oxytocin infusion discontinued, infusion may be resumed when all the In-Use Checklist criteria have been met.
If the Oxytocin has been discontinued for less than 30 minutes, restart the infusion at 1/2 the PREVIOUS rate
and increase per initial orders.
If the Oxytocin has been discontinued for more than 30 minutes, restart the infusion at 1 milliUnit/minute and
increase per initial orders. Physician ____________________________________________________________ Physician # _________________________ Authorization for therapeutic substitution is given unless checked here
Patient Identification Sutter Medical Center, Sacramento
A Sutter Health Affiliate Oxytocin Orders
21937 (4/30/09) ORDERS ...
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This note was uploaded on 12/26/2009 for the course PHYS 341 taught by Professor Mavromatis during the Spring '09 term at American University of Beirut.
- Spring '09