Biomedical subjects
Patsy L Ruchala
Publications and source records attributed to Patsy L Ruchala.
Current practice in oxytocin dilution and fluid administration for induction of labor.
OBJECTIVE: To determine the types of intravenous fluids used to dilute oxytocin for labor induction in a national sample of obstetric units, as well as the extent to which these fluids reflect current published guidelines. DESIGN: A descriptive design. SETTING: Questionnaires were mailed to nurse managers at 700 obstetric units chosen via systematic random sampling from eligible hospitals listed in The AHA Guide (1998). PARTICIPANTS: Two hundred fifty-six usable questionnaires were included in data analysis. MAIN OUTCOME MEASURES: The Labor Induction Protocol Survey, consisting of eight questions relating to number of births per year, percentage of women whose labor is induced or augmented, methods used for induction of labor, intravenous fluids used to dilute oxytocin for induction of labor, the level of perinatal care of the unit, and the protocols units used to guide their practice in the use of oxytocin, was developed for this study. RESULTS: Approximately 98% of the responding sites follow the current recommendations for oxytocin dilution and mainline fluid delivery. However, 5 or 2% of the sites reported the use of 5% dextrose in water for both oxytocin dilution and the mainline intravenous solution. CONCLUSIONS: Although only 5 (2%) of the responding facilities indicated the use of 5% dextrose in water for both oxytocin dilution and the mainline intravenous solution, this may be clinically significant because of the serious nature of hyponatremia and the ease of its prevention. Nurses should be aware of the extent to which protocols for the infusion of oxytocin vary, despite what is documented as best practice and the potential consequences for their patients of implementing those protocols. Nurses who advocate for and participate in writing protocols that reflect the best-recommended practice for their patients will assist in ensuring that what is documented as best practice is actually implemented.
A comparison of the postpartum learning needs of adolescent mothers and their mothers.
OBJECTIVES: To describe the postpartum learning needs of adolescent mothers and their mothers and to compare the differences between the learning needs of the 2 groups of women. DESIGN: Descriptive cross-sectional survey design. SETTING: One university hospital and 2 private Midwestern hospitals. PARTICIPANTS: Convenience sample of 100 women (50 mother/daughter pairs). MAIN OUTCOME MEASURES: Postpartum teaching questionnaire-E, postpartum teaching questionnaire-F, and demographic questionnaire. RESULTS: There were no group differences between adolescent mothers and their mothers on baby-care items, but there were group differences on 3 maternal-care items: emotional changes (p < .001), resumption of sexual activity (p < .001), and birth control (p = .009). CONCLUSIONS: Nurses may need to use different teaching strategies for adolescent mothers and their mothers about resumption of sexual activity, but the teaching strategies necessary for other postpartum topics may be similar. Further research is needed to determine where those similarities may be and to determine the most effective teaching strategies for each group of mothers.