dinoprostone

Assessment

Abortifacient

• Monitor frequency, duration, and force of contractions and uterine resting tone. Opioid analgesics may be administered for uterine pain.

» Monitor temperature, pulse, and BP periodically throughout therapy. Dinoprostone-induced fever (elevation >1.1°C or 2°F) usually occurs within 15–45 min after insertion of suppository. This returns to normal 2–6 hr after discontinuation or removal of suppository from vagina.

» Auscultate breath sounds. Wheezing and sensation of chest tightness may indicate hypersensitivity reaction.

» Assess for nausea, vomiting, and diarrhea in patients receiving suppository. Vomiting and diarrhea occur frequently. Patient should be premedicated with antiemetic and antidiarrheal.

» Monitor amount and type of vaginal discharge. Notify health care professional immediately if symptoms of hemorrhage (increased bleeding, hypotension, pallor, tachycardia) occur.

• Monitor uterine activity, fetal status, and dilation and effacement of cervix continuously throughout therapy. Assess for hypertonus, sustained uterine contractility, and fetal distress. Insert should be removed at the onset of active labor.