Question

mig 1900 Suzanne's contractions are 2-3 minutes apart, last 70-80 seconds, and are of very strong intensity. She shows frustration, loss of control, has nausea, and vomits small amounts. She tells her husband, "Get away, do not touch me!" As the nurse enters the room, she asks for a bedpan and says she feels like she has to have a bowel movement. She screams, "I have to push!"

Answer 1

1. Susanne is in the first stage transition phase of the labor.

2. Interventions at this stage are:

• Offer lots of encouragement and praise
• Avoid small talk
• Routinely observe contractions
• Routine abdominal and vaginal examinations has to be done
• Continue breathing with her
• Help guide her through her contractions with encouragement
• Encourage her to relax between contractions
• Don’t think that there is something wrong if she seems to be angry – it is a normal part of the transition

3. Susanne is going to be fully dilated cervix. Now it is 9 Cm and she is progressing in the first stage of labor.

and tell her to relax, because a little more time is there to get the cervix fully dilated. This is the transition phase first stage of true labor. If the lady is a multigravida, the dilatation may happen fast to full and the delivery also will be quick. If she is primigravida, usually another one more hour is needed for full dilatation.

If the cervix is 10 Cm dilated, this means it is fully dilated. Now delivery can happen in another 60 minutes mostly.

If she is fully dilated but no urge to push means, the baby has not descended down . So can wait some more time for the baby to descend. The uterus is over worked and resting, so can allow the mother to rest for some time, while under strict supervision. Allow her to empty the bladder, as a full bladder can obstruct the uterine activity. By the time she gains her energy back, and if the baby descends down, then there will be quick delivery, so be ready with everything.

4. The partogram has to be maintained by the nurse .

• Assess the cervical dilatation and record it.
• Check the descend of the fetal head towards the cervix and record it.
• Record whether the amniotic membrane is intact or ruptured
• Record the contractions with duration, frequency and intensity
• Record any medications given.