Do you insert Cytotec for inductions?

  1. Just a quick question, I started a new travel assignment at a hospital where the nurses are expected to insert the Cytotec for inductions. From every place I had ever worked and everything I had read this was a big "no-no". I thought I also recall reading somewhere that nurses should refuse to insert the Cytotec has it had not been approved for this usage and if something happened we could be held liable for just being present when a doctor inserts it. What goes on in other facilities?
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  2. 14 Comments

  3. by   SmilingBluEyes
    Indeed we do. it's always been the nurses that do there.

    in the other facility I used to work, we did NOT DO VAGINAL CYTOTEC, but ORAL, so it was not an issue. I think oral cytotec was AT LEAST AS EFFECTIVE----- and it's just as unpredictable.

    It IS now being recognized as approved for cervical induction as well as pp hemorrhage, much the same way Brethine, the asthma drug, is approved for off-label use as a tocolytic.
    Last edit by SmilingBluEyes on Mar 15, '04
  4. by   Connie John 3:16
    Nurses Insert Cytotec Where I Work Also. Check Policy And Procedures At Your Hospital.
  5. by   jbmrn
    Where I work the nurses can only administer Cytotec orally (which we hardly ever do). The MDs do the vaginal Cytotec, which seems to be the preferred method.
  6. by   AlaskaKat
    Yup, we do. Also we place cervidil and prostin gel.
  7. by   palesarah
    Nurses insert miso also at my facility. The MD/CNM will usually insert the first dose.
  8. by   USC2001
    We use Cytotec for ripening of the cervix the night before a Pitocin induction. The docs used to insert the first dose and then we would insert subsequent doses. However.... there was a big uproar in Novemeber or so becuase the SC state board of nursing issued an advisory opinion against nurses placing cytotec on a viable fetus. The docs freaked when we told them that we would not place it anymore. I had one get verbally abuse about us "d*mn nurses" not doing our job and we should do what they tell us to do. He got reported real fast. Anyway... we still place on fetal deaths and for PP bleeding. Now more of them use Cervidil so can they can place it at 6p and then go home.
  9. by   Rep
    Cytotec is a drug for peptic ulcer, one of its side effects is uterine contraction. If I am working in a hospital and was asked to do this procedure on a pregnant woman then I would definitely decline since I believe that life begins upon conception.
  10. by   USC2001
    Quote from Rep
    Cytotec is a drug for peptic ulcer, one of its side effects is uterine contraction. If I am working in a hospital and was asked to do this procedure on a pregnant woman then I would definitely decline since I believe that life begins upon conception.
    Huh?
    Thou Cytotec can be used to abort, we are talking about how in L&D we use it to induce a term pt into labor. Just like they use Pitocin, Prostaglandin gel, etc.
  11. by   Rep
    Quote from USC2001
    Huh?
    Thou Cytotec can be used to abort, we are talking about how in L&D we use it to induce a term pt into labor. Just like they use Pitocin, Prostaglandin gel, etc.

    Got your point. Cytotec to induce labor in full term pt. I have to go back to basic knowledge if ever I go back to nursing. THANKS! :imbar
  12. by   L&D_RN_OH
    Quote from USC2001
    However.... there was a big uproar in Novemeber or so becuase the SC state board of nursing issued an advisory opinion against nurses placing cytotec on a viable fetus.
    Are you sure this is for induction? We place Cytotec for induction. But we are not permitted to place Cytotec for termination on a viable fetus, for sepsis, amnionitis, etc. We can place Cytotec for a fetal demise though.
  13. by   USC2001
    Quote from L&D_RN_OH
    Are you sure this is for induction? We place Cytotec for induction. But we are not permitted to place Cytotec for termination on a viable fetus, for sepsis, amnionitis, etc. We can place Cytotec for a fetal demise though.
    Here is what it says on the web site:
    Advisory Opinions
    Question 44
    Question: Is it within the role and scope of practice for the registered nurse (RN) to insert prostaglandin analogs (e.g., misoprostol) into the vagina for cervical ripening or induction of labor with a viable fetus?

    The Board of Nursing has determined that it is NOT within the role and scope of practice for the RN to administer prostaglandin analogs (e.g., misoprostol) vaginally for cervical ripening or induction of labor with a viable fetus.

    The statement is an advisory opinion of the Board of Nursing as to what constitutes competent and safe nursing practice.
    http://www.llr.state.sc.us/POL/Nursi...visoryop44.htm
  14. by   tamrnmomof4
    No we just started using it again for induction..and no the physicans are responsible for inserting the med!

    Tammy

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