A primigravida at term is receiving oxytocin (Pitocin) to augment labor. Which adverse effect is the nurse most concerned about?

A primigravida at term is receiving oxytocin (Pitocin) to augment labor. Which adverse effect is the nurse most concerned about?

• A. Hyperstimulation
• B. Uterine atony
• C. Hypertension
• D. Placental abruption

Answer: (A)

When oxytocin is used to augment labor, the primary adverse effect the nurse must watch for is uterine tachysystole, or hyperstimulation. This means contractions become too frequent or last too long, with insufficient relaxation between them. The danger is that rapid, sustained contractions dramatically reduce placental blood flow, compromising fetal oxygen delivery and increasing the risk of fetal distress. In a term primigravida, this scenario is especially worrisome because the baby relies on steady placental perfusion during active labor. Uterine atony is a postpartum problem, not an intrapartum one, so it isn’t the immediate concern with augmentation. Hypertension isn’t a direct or common consequence of Pitocin use. Placental abruption can be associated with severe contractions, but tachysystole is the specific, most common mechanism by which augmentation elevates risk to the fetus, making hyperstimulation the best answer. If tachysystole occurs, the typical response is to stop the oxytocin and reassess fetal status and maternal condition.

When oxytocin is used to augment labor, the primary adverse effect the nurse must watch for is uterine tachysystole, or hyperstimulation. This means contractions become too frequent or last too long, with insufficient relaxation between them. The danger is that rapid, sustained contractions dramatically reduce placental blood flow, compromising fetal oxygen delivery and increasing the risk of fetal distress. In a term primigravida, this scenario is especially worrisome because the baby relies on steady placental perfusion during active labor.

Uterine atony is a postpartum problem, not an intrapartum one, so it isn’t the immediate concern with augmentation. Hypertension isn’t a direct or common consequence of Pitocin use. Placental abruption can be associated with severe contractions, but tachysystole is the specific, most common mechanism by which augmentation elevates risk to the fetus, making hyperstimulation the best answer. If tachysystole occurs, the typical response is to stop the oxytocin and reassess fetal status and maternal condition.