Rationale for the revision of oxytocin administration protocols.

A physiologic rationale, based on a review of the literature, is provided for implementing a protocol for labor induction or augmentation with intravenous oxytocin infusion. Oxytocin dosage should simulate the amount normally released endogenously during labor. Recent studies suggest that smaller dose regimens are as effective as previous larger dose regimens and that adverse effects of oxytocin are dose related. Nurses must know the relationship between the physiology of normal labor and the pharmacokinetics and safe administration of oxytocin during labor.