NATIONAL INSTITUTE OF NURSING EDUCATION

PGIMER, CHANDIGARH

LESSON PLAN ON: INDUCTION OF LABOR

SUBMITTED TO: SUBMITTED BY:

Mrs. V. VENKADALAKSHMI GARIMA SHARMA
ASSOCIATE PROFESSOR MSc. (N) 1nd year
NINE, PGIMER NINE, PGIMER
SUBJECT - Obstetric Nursing and Midwifery.

TOPIC - Induction Of Labor

GROUP OF STUDENTS -

NO. OF STUDENT -

METHOD OF TEACHING - Demonstration

TIME OF TEACHING -

DURATION - 45-50 minute

VENUE -

SUPERVISOR - Mrs. V. Venkadalakshmi

PREVIOUS KNOWLEDGE - Student have some previous knowledge about Endometrial Biopsy.

GENERAL OBJECTIVE - At the end of the class student will have knowledge regarding the topic.

SPECIFIC OBJECTIVE - At the end of the class the student will be able to:

 Introduce the topic.

 Define Induction of Labor
 Explain the purposes of Induction of Labor
 Enumerate the articles used in Induction of Labor
 Discuss the steps of procedure.

S.N SPECIFIC TIME CONTENT TEACHING LEARNING EVALUATION

 O METHOD
OBJECTIVE

INTRODUCTION: TEACHING A.V. AIDS

METHOD
1. At the end of 2min Most of the women have onset of labor spontaneously, For
the class some women drugs are given artificially to stimulate the
student will uterine contraction. Thus, nurses working with these women
be able to in labor and delivery room must have good understanding Lecture cum PowerPoint
discussion presentation What is the
introduce the of uterine introduction of
topic. Induction of
Labor?
DEFINITION
2. Definition of 2min
Induction Of It is the procedure where pregnancy is deliberately
terminated after 28 weeks of pregnancy, as a matter of What is
Labor. Lecture cum PowerPoint
urgency, either for the poacher or the fetus, by any method - Definition Of
discussion presentation
medical, surgical or combined, which aims at initiation of Induction Of
and vaginal delivery. Labor?

PURPOSES: Lecture cum PowerPoint What are the

5min
Enumerate discussion presentation purposes of
3. the purposes  To prevent risks of continuation of pregnancy either Induction Of
of to the mother or to the fetus. (Indication of induction Labor?
endometrial of labor- Pre-eclampsia, eclampsia, maternal medical
biopsy. complications-diabetes mellitus, chronic renal
disease, postmaturity, abruptio placenta, Intrauterine
growth restriction, Rh- isoimmunization. premature
 rupture of membranes. ferts with a major congenital
farmaly; intrauterine death of fetus,
oligohydramnios, polyhydramnios,/

4. Enlist the 15min ARTICLES:

articles used
 Hand-washing article for cleaning hands to prevent
in induction infection.
of labor?  Screen for providing privacy. Demonstration PowerPoint What are the
 Spot light or flash light for proper visualization of presentation articles used in
vein for insertion of venflow. On induction Induction OF
 Stethoscope. of labor Labor?
 Mask and apron to maintain asepsis and prevent
cross infection, sterile gloves to maintain asepsis and
prevent cross infection
Tray containing following items :

Small mackintosh to prevent soiling of bed sheet.

Article for cleansing the skin--spirit, betadine,
adhesive plaster,
sterile
cotton swabs, kidney tray.
• Venflon for infusion of oxytocin in normal saline.
• A sterile IV set for giving oxytocin solution.
• Disposable syringe.
Distilled water for oxytocin preparation.
 • Normal saline solution for preparing oxytocin
solution for induction of labor.
Explain the • Medication: Oxytocin/Cerviprime/ Mifepristone.
steps of
5. procedure for STEPS OF PROCEDURE IN INDUCTION OF LABOR What are the
Induction of BY OXYTOCIN steps of
Power point procedure for
Labor  PREPROCEDURAL STEPS: presentation Induction of
Labor?
 Ask mother to void to empty the bladder and make
her comfortable before procedure.
 Check the fetal heart rate, uterine contraction rate,
abdominal and vaginal findings before induction of
labor.
 Prepare the perineal area to minimize the infection
(shave the perineal area).
.
 Enema to be given before induction to induce labor.
Check written order carefully to avoid any mistake.
Keep all the articles ready to save the time.
 Explain the procedure to reduce anxiety of mother.
Wash hands to prevent cross infection.

INTRAPROCEDURAL STEPS :

 Place mackintosh under the mother's arm.

 Set up the IV tubing: pump and adjust the
drops/min.
 Add the lorded oxytocin in IV bottle after accurate
dose calculation, prescribed by the doctor.
POSTPROCEDURAL STEPS :

 Observe uterine contraction for intensity duration Power point

and frequency and record accurately. presentation
 Record fetal heart sound throughout the course of
drip. watch for vital signs of mother.
 When strong contraction lasting over 60 seconds and
occurring frequently with intervals c3 minutes, tonic
uterine contraction, fetal distress, occurrence of
increased or decreased fetal movement, and notified
immediately to doctor.
 Gradually increase the drops once prescription of
doctor ensuring that everything is normal.
 Contraindication of induction of labor is
cephalopelvic disproportion, fetal distress, previous
cesarean section, multipl birth. heart conditions,
prematurity, unengaged presentation.
 STEPS OF PROCEDURE IN INDUCTION OF
LABOR BY PROSTAGLANDIN
 PREPROCEDURAL STEPS
 Approach the woman pleasantly to establish
rapport. check written order carefully to
avoid any mistake.
 Keep all the articles ready to save time.
 Explain the procedure to the mother to reduce
anxiety.
 Wash hands to prevent cross infection.
 Provide privacy to reduce anxiety.
INTRAPROCEDURAL STEP:

 Assist the doctor to insert prostaglandin

(Misoprostol) gel into the posterior fornix
close to cervix.
POSTPROCEDURAL STEPS :

 Advice the woman to stay recumbent as

contraction begins.
 Observe uterine contraction for intensity,
duration and frequency, and record
accurately.
 Record fetal heart sound.
 Watch for vital signs of mother.
 Doctor must be notified immediately for any
abnormal observation.
SURGICAL INDUCTION :

ARTICLES:

 Sterile tray
 Bowl and swabs
 Sponge-holding forceps
 Kocher (to rupture the membranes)
 Kidney tray
 Perineal pads. Enlist the
intraprocedure
PREPROCEDURAL STEPS : steps?
 Approach the woman pleasantly to establish rapport.
 Check written order carefully to avoid any mistake.
 Keep all the articles ready to save time,
 Explain the procedure to the mother to reduce
anxiety.
 Wash hands to prevent cross infection.
 Provide privacy to reluce anxiety.
INTRAPROCEDURAL STEPS :

 Assist the doctor to pass a long Kocher up to

the cervical canal and rupture the membranes
 After perineal and vaginal toileting with
antiseptic solution and usual draping with
sterile towels, doctor will introduce two
fingers into the vagina smeared with
antiseptic ointment.
 The index finger is passed through the
cervical canal beyond the internal os.
 The membranes are swept free from the
lower segment as far as reached by fingers.
When one or two fingers g. aspect of the
fingers up to the membranes. The blades are Enlist the
open to seize the membrane and are torn by postprocedure
twisting movements which is followed by steps?
visible escape of amniotic fluid.
 POSTPROCEDURAL STEPS :

 Observe uterine contraction for intensity

duration and frequency and record
accurately.
 Record fetal heart sound.
 Watch for vital signs of mother.
 Assess fetal heart rate, note the color and
amount of the amniotic fluid, status of cervix,
station of head, and presence or absence of
cord prolapsed.
Summarize  Doctor must be notified immediately for
abnormal observation.
SUMMARY

Till now we were discussed about the:

 Introduction
 Purposes for Induction of Labor
 Articles needed for Induction of labor
 Steps for Induction of labor.

REFERENCES
Enlist the
references. 1. Ghai S.Clinical Nursing Procedures.2nd edition,
CBS publishers and distributors pvt. Ltd..New
 Delhi;690-691
2. TNAI manual, clinical procedures
3. www.lippincottsnursing centre.com
4. Dutta DC Textbook of Gynecology, 6th edition. New
delhi central book agency 2004
5. RamanAV.MaternityNursing,19th
edition.WoltersKluwer(india)Pvt.ltd.
Delhi;2011
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