A multigravida client at 40+ weeks gestation is induced with oxytocin. An intrauterine pressure catheter (IUPC) is in place when the membranes rupture after 5 hours of active labor. Which finding should require the nurse to implement further action?

• A. Labor has progressed at 1 cm/hr dilation.
• B. Intensity of contractions is 130 mm Hg.
• C. Contractions lasting 60 to 80 seconds.
• D. Oxytocin is infusing at a rate of 30 mU/min.

Answer: (B)

When labor is augmented with oxytocin and monitored with an intrauterine pressure catheter, the strength of each contraction matters as much as how often they occur. A contraction that peaks at 130 mm Hg indicates tachysystole, meaning the uterus is contracting too forcefully. This strong, frequent stimulation can reduce placental blood flow and impair fetal oxygenation, so it signals a need for immediate action to protect the fetus. The typical response is to adjust the labor augmentation by reducing or stopping oxytocin, then reassessing the fetal heart rate and maternal status, with further measures (such as fluids, repositioning, or tocolysis) as dictated by the clinical situation.

The other findings here align more with expected labor progression or routine monitoring. A dilation rate around 1 cm per hour in a multigravida at term is within normal active-labor progress. Contractions lasting 60–80 seconds fall within a generally acceptable range, not by themselves requiring escalation. A relatively high infusion rate of oxytocin could contribute to tachysystole, but on its own does not mandate action without showing an adverse fetal response or signs of excessive contraction intensity.