Question

Looking of any signs of bleeding and position of umbilical cord. If any sign of bleeding vaginal examination can not be performed With examination dilation and consistency of the cervix can be checked. The degree of effacement is determined by the presenting part and rate the station, if membranes are intact along with position of the fetus. (Silbert-Flagg, J) 11. During the vaginal exam, you can feel a firm surface against the cervix and a softer triangular shape in the upper right portion (between 12 and 3 on a clock). You also notice a small amount of blood. What is the presentation and position of the fetus and what causes the blood 12. Annie's cervix has dilated to 5cm and she is 100% effaced. She asks what that means and how much longer she has.to go. What do you tell her? 13. Annie complains of a dry mouth and wants a diet coke to drink. What nourishment is recommended for the laboring woman? 14. As Annie's contractions increase in intensity, Annie's support person begins to pace around the room wringing his hands. How can you help him during the labor and delivery process? What can he do to support Annie? 15. Annie requests pain medication What IV pain medications, if any, can be given to the laboring woman? 16. Annie requests anesthesia during her labor, but is uncertain of which type she should have Compare 2 types of anesthesia and indicate the following: site of administration, when given areas affected, major disadvantages and nursing considerations 17. Explain how Annie should breathe during the different phases of labor O 354 8

Answer 1

11. By this vaginal examination it is known that Annie had a vertex presentation and the position of the fetus is Right occiput anterior. The reason for the bleeding is that, she is now in the first stage of labor and there will be dilation of cervix cause it bleed.

12. Cervix needs to be dilated for fully 10 cm and needs to be soften and thin for 100%, which would lead you to baby deliver normally. And for you now it will take over eight more hours to deliver your baby.

13. Annie should be recommended to drink pure water or some fresh fruit juices. It will be helpful for her power to bear down and it is not recommended to give more complex or heavy food during this time.

14. Probably Annie's support person would not have any experience about the labor process, So as a nurse, they should explain little bit about the pregnancy stages and tell him to be with her always. Encourage him that everything will move soon and it will be normal and fine for Annie. Advice him just to sit with her and be a comfortable one for her.