you are the charge nurse working in labor and delivery at a local hospital. d.h. comes to the unit having contractions and feeling somewhat uncomfortable. you take her to the triage room to provide privacy, have her change into a gown, and ask her three initial questions to determine your next course of action, that is, whether to do a vaginal exam or to continue asking her more questions.
1. What are your three initial questions and why would you ask them?- How many weeks gestation is she? – to determine if she could be feeling Braxton Hickscontractions or true - How are the contractions? Far apart? Lasting? Pain? – characteristics of the contractions will help determine if they are true or false; if they are regular or irregular, does the pain go away with walking as they do in false- Are you having any vaginal discharge? – to determine if her water has broken or if she is having any bleeding2. D. H. has contractions 2 to 3 minutes apart that last for 45 seconds. It is her third pregnancy(g3p2). Her bag of water is intact. You determine it is appropriate to ask her more questions before doing the vaginal exam. What information do you need?- Did you have any complications with your previous deliveries? Where they vaginal or C-section deliveries? Do you have any allergies? Have you discussed pain medication with your doctor? Would you like anyone else in the room with you? 3. What assessment(s) should you make to gain further information from D. H.?- Assess position of the baby using Leopold’s maneuver to determine where to place the doppler, get a BL FHR & contraction pattern from the toco, assess maternal VS, pain assessment, temperature, Perform a vaginal exam to check for dilation, effacement, & station4. You check her, and she is 80% effaced and 4 cm dilated. The FHR is 150 beats/min. and regular. She is admitted to labor and delivery. What should you do now as the nurse?- Assess contractions q30min, maternal VS every hour, & FHR q30min; encourage the women to void so a full bladder won’t interfere with fetal descent; provide comfort measures like, back rubs, cool cloth on forehead, assist with position changes; give ice chips for dry mouth/lips5. List the stages of labor and tell which stage D. H. is in, and why you put her in this stage.- First stage with 3 phases: Latent/Early, Active, Transition; Second stage, Third Stage, &Fourth stage- D.H. is in the first stage in the active phase because in this phase the cervix dilates 4-7 cm, has contractions 2-5 min apart, lasting 40-60 sec and she is dilated 4 cm with contractions 2-3 min apart, lasting 45 sec. 6. Decelerations occur in an early, variable, or late pattern. What is the significance of each and what nursing care should you provide for each?- Early Decelerations are due to head compression during uterine contractions. No nursing care is needed.- Variable Decelerations are due to cord compression. Nursing care is change maternal position change, stop Pitocin if being used, vaginal exam to assess for prolapsed cord, give O2, notify the physician

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15-12-2022
Health

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you are the charge nurse working in labor and delivery at a local hospital. d.h. comes to the unit having contractions and feeling somewhat uncomfortable. you take her to the triage room to provide privacy, have her change into a gown, and ask her three initial questions to determine your next course of action, that is, whether to do a vaginal exam or to continue asking her more questions.
1. What are your three initial questions and why would you ask them?- How many weeks gestation is she? – to determine if she could be feeling Braxton Hickscontractions or true - How are the contractions? Far apart? Lasting? Pain? – characteristics of the contractions will help determine if they are true or false; if they are regular or irregular, does the pain go away with walking as they do in false- Are you having any vaginal discharge? – to determine if her water has broken or if she is having any bleeding2. D. H. has contractions 2 to 3 minutes apart that last for 45 seconds. It is her third pregnancy(g3p2). Her bag of water is intact. You determine it is appropriate to ask her more questions before doing the vaginal exam. What information do you need?- Did you have any complications with your previous deliveries? Where they vaginal or C-section deliveries? Do you have any allergies? Have you discussed pain medication with your doctor? Would you like anyone else in the room with you? 3. What assessment(s) should you make to gain further information from D. H.?- Assess position of the baby using Leopold’s maneuver to determine where to place the doppler, get a BL FHR & contraction pattern from the toco, assess maternal VS, pain assessment, temperature, Perform a vaginal exam to check for dilation, effacement, & station4. You check her, and she is 80% effaced and 4 cm dilated. The FHR is 150 beats/min. and regular. She is admitted to labor and delivery. What should you do now as the nurse?- Assess contractions q30min, maternal VS every hour, & FHR q30min; encourage the women to void so a full bladder won’t interfere with fetal descent; provide comfort measures like, back rubs, cool cloth on forehead, assist with position changes; give ice chips for dry mouth/lips5. List the stages of labor and tell which stage D. H. is in, and why you put her in this stage.- First stage with 3 phases: Latent/Early, Active, Transition; Second stage, Third Stage, &Fourth stage- D.H. is in the first stage in the active phase because in this phase the cervix dilates 4-7 cm, has contractions 2-5 min apart, lasting 40-60 sec and she is dilated 4 cm with contractions 2-3 min apart, lasting 45 sec. 6. Decelerations occur in an early, variable, or late pattern. What is the significance of each and what nursing care should you provide for each?- Early Decelerations are due to head compression during uterine contractions. No nursing care is needed.- Variable Decelerations are due to cord compression. Nursing care is change maternal position change, stop Pitocin if being used, vaginal exam to assess for prolapsed cord, give O2, notify the physician

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syedtahir20 syedtahir20 · Answer 1 · 2022-12-21T18:10:59-05:00

Labor can be scary for women, especially the first birth. Women also faces experience physical sensations which ranges from discomfort to severe pain during labor pain. Helping a woman feel at ease and aware of her situation can help reduce the physical pain and stress of labor and delivery. Women can be helped with this by having adequate care, timely information, comfort, support and reassurance during labor and delivery. Also, it is important to be polite and courteous whenever possible by explaining what you are going to do and why, and being polite to her and her family. It is also important to maintain privacy during childbirth, by protecting the woman as much as possible for all procedures, or by providing a veil.

1). If a pregnant woman comes to the delivery room with weakness and discomfort, the following questions help to decide what care to give her.

Since when do you feel pain? Is there a specific cause of pain (such as trauma or other mechanical stress)
Is there blood? (During true labor, contraction of the uterus occurs, and bleeding with mucus is a sign of true labor.)
Where do you feel severe pain and how often does the pain occur? (False labor is a periodic contraction of the uterine muscles that causes pain in the abdomen but does not increase and change with movement, and bleeding is not seen with stool.)
True labor causes severe pain in the back and becomes more severe with time. Real labor leads to birth. Therefore, based on the questions above, the nurse can determine whether the patient needs treatment for pain and needs to prepare for childbirth.

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