YOUR CLIENTV RINA 35 YEARS OLD,G1 P0 ARRIVES VIA WHEELCHAIR TO THE LABOR AND BIR
ID: 89034 • Letter: Y
Question
YOUR CLIENTV RINA 35 YEARS OLD,G1 P0 ARRIVES VIA WHEELCHAIR TO THE LABOR AND BIRTH UNIT IN ACTIVE LABOR FROM EMERGENCY DEPARTMENT. RINA IA AT 41 WEEKS AND 3 DAYS OF GESTATION. SHE STATES SHE IS SCHEDULED FOR INDUCTION OF LABOR IN 2 DAYS.THERE IS MODERATE VAGINAL BLEEDING ON THE TOWEL IN THE CHAIR.RINA STATES HER MEMBRANES RUPTURED ABOUT 30 MINUTES AGO AND THERE WAS NOT MUCH WATER MOSTLY BLOOD.NOW THE BABY IS NOT MOVING MUCH.THIS IS YOUR SECOND DAY IN THE LABOR AND BIRTH UNIT WITH AN RN MENTOR.SHE APPLIES ULTRASOUNDV AND A TOCODYNAMOMETER FOR FETAL MONITORING.YOU ARE ASKED TO ASSIST YOUR MENTOR BY TAKING VITAL SIGNS. RINA VITAL SIGNS ARE TEMPERATURE 37*C,PULSE 98 RESPIRATION 28B/P 100/54 AND OXYGEN SATURATION 91%.FETAL HEART HEART IS BETWEEN 170AND 180 BREATHS PER MINUTE ,THE TRACING LOOKS GOOD SMOOTH. CONTRACTION ARE OCCURING EVERY 2 MINS. HER PAIN SCORE IS 8/10. IS THERE EVIDENCE THAT RINA AND HER FETUS ARE AT RISK? DESCRIBE THE FINDINGS FROM RINAS ADMISSION ASSSESMENT DATA THAT SUPPORT DECISIONS FOR CARE ON NICHD TERMINOLOGY? WHAT PRIORITIES FOR RINA CARE CAN BE DRAWN AT THIS TIME?DOES EVIDENCE OBJECTIVELY SUPPORT YOUR CONCLUSIONS?AREB THERE ALTERNATIVE PERSPECTIVES TO YOUR CONCLUSION?
Explanation / Answer
Labor is established when there is dilation in the cervix of more than 3cm and if the cervix has opened with regular contractions. During the first stage of labor, it is better to eat and drink as the person needs some energy to handle labor.
In the second stage of labor, the cervix will dilate to 10cms which gives a severe pain as measured with the scale of 8/10 as given in the question. So, the pain experienced by Rina is similar to what is expected at that moment. This stage is where the contractions are usually occurring every 2 to 3 mints interval and last for about 60 to 90 seconds.
As the pregnant woman at this stage is common to feel frustrated and irritated without having any time to rest, it is common for the woman at labor to experience these clinical conditions as mentioned in the question.
As the contractions increase, the woman at labor might be sweaty, stomach upset, feel hot or cold. The person can help herself if she can breathe slowly although uneven breathing patterns are mostly observed at this time.
If you think about the risk of the woman at the second stage of labor, every two labor will not be same as per the statistics. Pushing the baby along with the feeling of intense pressure inside with a feeling of bowel movement along with the contractions of the cervix is a situation that is encountered by every woman giving birth to a child. Though it is risky, it is essential and healthy sign of expecting the child birth in normal way.
Giving the person oxytocin drip if necessary to increase the contractions and fasten the delivery is one way of reducing the slow process. Allowing the delivering woman to attain a position that can help her to easily deliver the baby is another way of hastening the smooth delivery process.
The above details mentioned are available from the hospital services offered in their websites.
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