Caring for Women in First Stage of Labor

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Questions and Answers

What should be reported as a sign of fetal distress during continuous monitoring?

Change in maternal blood pressure

Abnormal heart rate patterns (correct)

Normal fetal movements

Increased maternal heart rate

Which non-pharmacological method is recommended for managing pain during labor?

Administration of sedatives

Using aromatherapy with essential oils (correct)

Encouraging prolonged bed rest

Offering anti-inflammatory medications

What is an important aspect of providing emotional support during labor?

Focusing solely on physical pain management

Ignoring cultural beliefs of the woman

Discouraging involvement of labor companions

Providing reassurance regarding the pain of labor (correct)

Which position should be avoided to prevent pressure on the vena cava during labor?

Supine position Signup and view all the answers

What is recommended to prevent dehydration during labor?

Offering fluids like water or fruit juice Signup and view all the answers

How can bladder care impact fetal descent during labor?

Preventing a full bladder can promote fetal descent Signup and view all the answers

Which pharmacological option is specified to avoid during active labor?

Sedatives due to risk of neonatal respiratory depression Signup and view all the answers

What role does a labor companion play during the labor process?

Providing comfort and potentially shortening labor Signup and view all the answers

What characterizes the Latent Phase of labor?

Mild, irregular contractions with little need for assistance. Signup and view all the answers

During which phase of labor is there an increased need for support and pain management?

Active Phase Signup and view all the answers

What is the primary objective of nursing care during the first stage of labor?

Ensuring the woman feels supported and in control. Signup and view all the answers

What is the primary goal for a nursing diagnosis of anxiety related to stress of labor?

Client states she feels in control of her situation. Signup and view all the answers

How frequently should maternal vital signs be monitored during labor?

Every 4 hours Signup and view all the answers

Which contraction pattern is typical during the Transition Phase?

Strong and frequent contractions. Signup and view all the answers

What is the purpose of the partograph in managing labor progress?

To identify interventions needed during prolonged labor. Signup and view all the answers

What is the normal range for fetal heart rate (FHR) during labor?

120-160 bpm Signup and view all the answers

Which intervention is appropriate for a nursing diagnosis of powerlessness related to the duration of labor?

Promote independence during latent phase. Signup and view all the answers

What is a critical aspect of documenting during labor?

Note any pain relief methods used and their effectiveness. Signup and view all the answers

What nursing action should be taken during contractions in labor?

Encourage deep breathing exercises. Signup and view all the answers

Which goal corresponds to the nursing diagnosis of risk for fluid volume deficit related to prolonged lack of oral intake?

Client states she does not feel thirsty. Signup and view all the answers

Why is it important to respect a woman's birth preferences during labor?

It can improve her overall satisfaction and experience. Signup and view all the answers

Which complication should be closely monitored during labor?

Fluid intake below normal levels. Signup and view all the answers

What is a suitable intervention for managing altered comfort due to pain during labor?

Utilize non-pharmacological pain relief methods. Signup and view all the answers

What should be monitored to assess for fetal distress during labor?

Abnormal fetal heart rate patterns. Signup and view all the answers

Study Notes

Caring for the Woman During the First Stage of Labor

The first stage of labor is divided into three phases: latent, active, and transition.
Latent phase: Cervical dilation 0-3 cm, mild irregular contractions, the woman can be relatively independent.
Active phase: Cervical dilation 4-7 cm, more intense regular contractions, increased need for support and pain management.
Transition phase: Cervical dilation 8-10 cm, strong frequent contractions, women may feel overwhelmed and require continuous support.
Key nursing care goals:
- Monitoring maternal and fetal well-being continuously.
- Managing pain through pharmacological and non-pharmacological methods.
- Respecting the woman's birth preferences and providing culturally sensitive care.
- Advocating for the woman's needs and collaborating with the healthcare team.
Maternal monitoring:
- Vital signs: Monitor blood pressure, pulse, and temperature every 4 hours.
- Contraction patterns: Assess frequency, duration, and intensity of contractions.
- Cervical changes: Conduct vaginal exams every 4 hours to check for dilation and effacement.
Fetal monitoring:
- Normal FHR: Ranges from 120-160 bpm, checked every 30 minutes.
- Continuous monitoring: May be necessary in high-risk situations.
- Report any signs of fetal distress, such as abnormal heart rate patterns or meconium-stained fluid.
Managing pain and discomfort:
- Non-pharmacological methods:
  - Encourage position changes to promote comfort and fetal descent.
  - Utilize breathing exercises.
  - Apply massage and touch for comfort, especially on the lower back.
  - Consider hydrotherapy through warm showers or baths for relaxation.
  - Use aromatherapy with essential oils to aid in relaxation.
- Pharmacological options:
  - Epidurals can provide significant pain relief during labor.
  - Analgesics may be given to relieve pain and anxiety in early labor.
  - Avoid sedatives in active labor to prevent neonatal respiratory depression.
Emotional support:
- Reassurance: Encourage the woman, affirming that pain is a normal part of labor.
- Support Persons: Involve labor companions for additional emotional and physical support.
- Cultural Sensitivity: Ensure care aligns with the woman's cultural beliefs and practices.
Positioning and mobility:
- Encourage positions like standing, walking, squatting, or leaning over the bed.
- Avoid lying supine to prevent pressure on the vena cava, which can reduce blood flow to the placenta.
Hydration and bladder care:
- Hydration: Encourage the woman to drink fluids like water or fruit juice and offer ice chips.
- Bladder Care: A full bladder can obstruct fetal descent; encourage urination every 2 hours.
Companionship and support:
- A labor companion can provide comfort, potentially shortening labor.
- Ensure the companion is informed about the woman's progress and included in the process.
Documentation:
- Record maternal vital signs and contraction patterns.
- Document fetal heart rate and any significant changes in condition.
- Note any pain relief methods used and their effectiveness.
Use of Partograph:
- Plot cervical dilation, fetal descent, and contraction patterns.
- Identify if labor progresses normally or if interventions are necessary.

Nursing Diagnoses

Powerlessness related to the duration of labor:
- Goal: Client expresses preferences for positions and techniques to control pain.
- Interventions: Encourage position changes, promote independence during the latent phase.
Anxiety related to stress of labor:
- Goal: Client states she feels in control of her situation.
- Interventions: Provide emotional support, educate about labor progress, involve support persons.
Risk for fluid volume deficit related to prolonged lack of oral intake:
- Goal: Client states she does not feel thirsty; voids at least 30 mL per hour.
- Interventions: Encourage fluid intake, offer ice chips, monitor hydration status.
Altered comfort: Pain related to progress of labor:
- Goal: Client states labor pains are tolerable.
- Interventions: Utilize non-pharmacological pain relief methods, assess effectiveness regularly.
Risk for self-care deficit related to exhaustion from labor efforts:
- Goal: Client states a sense of cleanliness and well-being.
- Interventions: Assist with personal hygiene, provide frequent mouth care.

Complications to Watch For

Fetal distress: Monitor for abnormal FHR patterns or meconium-stained fluid.
Delayed labor progress: Evaluate if cervical dilation is slower than expected.
Maternal exhaustion or dehydration: Encourage rest and hydration to prevent complications.

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Description

This quiz covers the essential nursing care for women during the first stage of labor, including the phases of labor, maternal monitoring, and pain management strategies. Understand how to support women effectively while respecting their birth preferences. Test your knowledge about providing compassionate and culturally sensitive care during this crucial time.