Focus On Maternity Practice Exam

Hypertonic uterine dysfunction involves painful, frequent contractions that don’t effectively dilate the cervix, with the uterus staying overly tense and poorly coordinated. The priority nursing intervention is to relieve pain and induce relaxation because pain and anxiety raise sympathetic activity, increasing catecholamines that keep the uterus in a high-tone state. Providing analgesia (and sometimes mild sedation) helps reduce uterine tone, lowers oxygen demand, and improves placental blood flow, which can help fetal status and allow labor to progress. Augmenting with oxytocin would worsen the hypertonicity and isn’t appropriate. Ambulation isn’t the focus in this situation and may not relieve the underlying issue, and performing an amniotomy won’t address the excessive tone or improve perfusion.