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Essentials of Maternity, Newborn, and Women's Health Nursing Chapter 14: Nursing Management During Labor and Birth...

Essentials of Maternity, Newborn, and Women's Health Nursing

Chapter 14: Nursing Management During Labor and Birth

1. Desiree, a 28-year-old G2P1, is admitted to the labor and birth unit. Her birth plan indicates that she is planning natural childbirth without pharmacological interventions. She has attended childbirth education classes. Desiree is considered low risk based on her personal and family health history and physical exam. Her pregnancy has progressed without complications. She is approximately 38 weeks pregnant. Vaginal assessment reveals cervical dilation at 10 cm, 100% effaced, and +1 station. Position of the fetus is LOA. The external fetal monitor indicates a reassuring fetal heart rate at 130 beats per minute. Maternal status is stable. (Learning Objectives 1, 2, 6, and 9)

  1. Based on the vaginal assessment, identify the stage of labor and appropriate nursing interventions for this stage of labor.
  2. Explain how the nurse determined that the external fetal monitor would be appropriate for Desiree. What factors would necessitate a change to internal fetal monitoring during labor?
  3. Desiree says, “I’m not sure I can cope with the pain much longer.” How would you respond, considering her birth plan, stage of labor, and assessment data?
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Answer #1

1)Stage of labour of desiree is the cervical dilation is 10 cm which means she is in second stage of labour.It is called transitional stage.

Nursing interventions include.

Encouraging the patient to rest in between the contractions and ask her to be calm.

Provide privacy and fluids and ice chips so that she can be hydrated.Also monitor mother and child's vital signs.Amniotic fluid color should be monitored.

2)The reason taht the external fetal monitor is appropriate for desiree because the fetal heart rate is reassuring and there is no complications with mother's health and she doesn't have hypertension or diabetes.

3)I would explain calmly that she choose natural childbirth without any pharmological interbeninter and I would explain that she is in full cervical dilation and the pain should be short term and she can deliver the baby.

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