HELP!!! Which is the first? stop oxytocin? change position?

Hello everyone,

I am really tired with this problem.... I am confused and I do not know which one I should believe.... Please help!!!!

The situation of the question is.....

In labor / client is receiving oxtocin / FHR late deceleration

I learned from N○S○N that the priority nursing action is Changing her position. Next is Infusion IV → give oxygen → stop oxytocin →　call doctor

However, I took a question ( from K○P○A○). This says that the first action is Stop oxytocin.

Honestly... I do not care if which one is important. I really want to know which one is correct answer for NCLEX.....

And I hope I am not going to get this question at the real exam...

Change position first, cord can be compressed, if that doesn't work then you will stop the pit.

Thank you!! So.... Some people used only KAPLAN and passed NCLEX... I still do not know which materials I should believe.... However I do not want to get confused anymore!! I will follow that the first action is changing position.

Don't mean to confuse you, but I took kaplan and with late decelerations you want to stop the oxytocin first.

LATE DECELERATIONS: occur after the contraction peak---can be caused by things like placenta previa/abruptio/ pregnancy induced htn---means that there is uteroplacental deficiency. want to stop oxytocin and then position on left side

VARIABLE DECELERATIONS: occur anytime during the contraction---indicates chord compression---this is relieved by a change in the maternal position - so variable deceleration is the one you want to change maternal position first. if the variable contractions are prolonged then you want to give oxygen and discont oxytocin

EARLY DECELERATIONS: occur before the peak of a contraction---indicates fetal head compression --can occur during labor when the baby is being pushed out

late decelerations are the worst sign of fetal distress and require immediate intervention

i took and passed the nclex but i didn't have questions on this so i don't know if nclex thinks differently, but i memorized what kaplan said

Late decels you will stop the oxytocin.

Have you heard of VEAL/CHOP/MINE mnemonics?

V - variable decels; cord compression, move

E - early dcels; head compression, investigate (this is okay, moving mom is okay too)

A - accelerations; okay; nothing needed

L - late decels; placenta insufficiency; emergency

So if you are in late decels, you would want to stop the pitocin first and then move mom.

According to Saunders and ExamCram, you want to STOP if maternal hypotension occurs.

S=Stop the pitocin

T=Turn over the patient

O= Provide O2

P= If hypovolemia is present, push IV fluids

This kind of reminds me of what you do in a med rxn. if the med is aggravating the problem then you stop it and then continue on with treatment not vice versa.

I hope this helps :)

Thank you so much, RN-joy!! These expressions are very helpful for me!!

Thank you so much, jaconcha!! I didn't know VEAL/CHOP/MINE... And then you were also one of nursing students who understood that stop pitocin is the first action when FHR late decelerations.

Thank you so much, CEPJ!! [sTOP] is very easy to memorize;)

Well.... Saunders, ExamCram, and KAPLAN say 'Stop oxitocin' is the first step. First I thought NCSBN learning extension is most reliable because of NCSBN... which is closest to NCLEX. Also I wander How the students are taught from the teachers in nursing school in the US. Because many people have been confused about this question.

If the question has pitocin in it--> stop pitocin first.

Think about the action of Pitocin, it strengthens labor contractions. So if you change positions, how will that help if the pt is still getting pitocin. Remove the cause / contributing factor first and then you change positions etc.

OMG!! Thank you all for the answer!! I too was confused with the pitocin stop time!! Thank you for all the clarification!

Hello everyone,

I am really tired with this problem.... I am confused and I do not know which one I should believe.... Please help!!!!

The situation of the question is.....

In labor / client is receiving oxtocin / FHR late deceleration

I learned from N○S○N that the priority nursing action is Changing her position. Next is Infusion IV → give oxygen → stop oxytocin →　call doctor

However, I took a question ( from Kâ—‹Pâ—‹Aâ—‹). This says that the first action is Stop oxytocin.

Honestly... I do not care if which one is important. I really want to know which one is correct answer for NCLEX.....

And I hope I am not going to get this question at the real exam...

For NCLEX, purposes, I would stop the infusion and with Hurst with late decelerations you would always stop the infusion. Changing the position actually "delays care" and although it seems right it's not