CALAMBA DOCTORS’ COLLEGE

Performance Evaluation Checklist

Name: ________________________ Date: _______________

Year and Section: _______________

Instruction: Rate the nursing skill performance of the student based as follows: 5 = Perfect (91-100), 4 = Very
Satisfactory (85-90), 3 = Satisfactory (80-84), 2 = Poor (79-75), 1 = Need Improvement (74 and below)

Oxytocin Administration

Preparation 5 4 3 2 1 Comments
Explain the procedure to the patient
Provide privacy
Wash your hands.
Describe the equipment
Forewarn the patient that she may feel a pinch from the venipuncture
Equipment
Administration set for primary I.V. line
Infusion pump and tubing
I.V. solution as ordered
External or internal fetal monitoring equipment
Oxytocin
20G needle
Label
Preparation of equipment
1 Prepare the oxytocin solution as ordered
2 Rotate the I.V. bag to disperse the drug throughout the solution.
3 Label the I.V. container with the name of the medication.
4 Attach the infusion pump tubing to the I.V. container, and connect
the tubing to the pump
5 Attach the 20G needle to the tubing to piggyback it to the primary
I.V. line, or use an autosyringe connected to the primary I.V. line
6 Then set up the equipment for internal or external fetal monitoring.
Procedure
Administering oxytocin during labor and delivery
1 Help the patient to a lateral-tilt position, and support her hip
with a pillow
In the supine position, the gravid uterus presses on the maternal
great vessels, producing maternal hypotension and reduced uterine
perfusion.
2 Identify and record the fetal heart rate (FHR), and assess uterine
contractions
To establish baseline fetal status and evaluate spontaneous
maternal uterine activity.
3 Start the primary I.V. line using an 18G through-the-needle
catheter
This line to deliver not only oxytocin but also fluids, blood, or other
medications as needed.
4 Piggyback the oxytocin solution (metered by the infusion
pump) to the primary I.V. line at the Y injection site closest to
the patient. Piggybacking maintains I.V. line patency (which you'll
need to preserve if you discontinue the oxytocin infusion).
5 Begin the oxytocin infusion as ordered
6 Be prepared to start monitoring uterine contractions. Because
oxytocin begins acting immediately
7 Increase the oxytocin dosage as ordered.
8 Before each increase, be sure to time the frequency and
duration of contractions, palpate the uterus to identify
contraction intensity, and assess maternal vital signs and fetal
 heart rhythm and rate to ensure safety and to anticipate possible
complications.
9 Assist with comfort measures, such as repositioning the patient
on her other side, as needed.
10 To reduce uterine irritability, try to increase uterine blood flow.
Do this by changing the patient's position and increasing the infusion
rate of the primary I.V. line
11 To manage hyperstimulation, discontinue the infusion, administer
oxygen, and notify the physician.
12 After hyperstimulation resolves, resume the oxytocin infusion.
13 Monitor and record intake and output. Output should be at least
30 ml/hour. Oxytocin has an antidiuretic effect, so you may need to
administer an electrolyte-containing I.V. solution to maintain
electrolyte balance.
14 Watch for signs of oxytocin hypersensitivity such as elevated blood
pressure
15 Record maternal response to contractions, blood pressure, pulse
rate and pattern, and respiratory rate and quality on the labor
progression chart
16 Document FHR, oxytocin infusion rate, and intake and output
amounts. Describe uterine activity as well.
Ave. Score =

Grade: __________

Evaluated by:

__________________________
Clinical Instructor

Rating Scale
Range Descriptive Rating
4.51 - 5.00 Perfect
3.51 - 4.50 Very Satisfactory
2.51 - 3.50 Satisfactory
1.51 - 2.50 Poor
1.00 - 1.50 Need Improvement