a) A 22-year-old female (G1P0) arrived at
a) A 22-year-old female (G1P0) arrived at the L&D unit 4 hours ago with contractions every 10 minutes lasting 30-40 seconds. On the EFM, the baby is reassuring. The patient’s mother is with her at the bedside. The patient tells the RN that she “wants to try and go natural” and she doesn’t want any drugs during labor. Her prenatal record shows that she was consistent with her prenatal visits and her medical/social history was unremarkable. Vital signs are the following: BP 126/76, HR 92, RR 22 Cervical exam: 3 cm dilated, 50% effaced, -2 station 6 hours later the provider performs another vaginal exam and reveals there has been no change and determines that medications to help facilitate labor are indicated. What is the rationale for this? What classification of medications does the RN anticipate the provider ordering? b) The patient walks the halls with her mother. Every hour she returns to her room for 20 minutes of fetal monitoring and to check her vital signs. After the third hour, her contractions are 4-5 minutes apart, lasting 50-60 seconds, and are of moderate intensity. She is examined and found to be 6 cm dilated, 100% effaced, and -1 station. During the contractions, she can no longer talk and she still needs to use her special breathing with her sister that she learned in her childbirth education class period she is experiencing low back pain during each contraction and has decided to stop ambulating for now and asks if she can still have something for the pain. She wants to know what medications are available and if they will “hurt the baby.” What would be your response to her regarding pain medications that are available? What medications (and dosage if applicable) are safe to administer at this time and explain why. What stage of Labor and phase is this patient now in? Would this be a good time for her to have an epidural? Why or why not? She asks if the epidural will slow her labor down. What would your response be? What should the nurse do to prepare her for this procedure? What is your nursing diagnosis at this point? What interventions would be indicated? C) The patient changed her mind and has decided not to have an epidural or any medication at this time, and she continues to practice her breathing with her mother and sister. What is the nurse’s best response for alternative pain management? List at least three (3). d) Following the alternative pain management methods, the patient is examined again and found to be 8 cm, 100% effaced and -1 station and her membranes are still intact. The provider has arrived and suggests that he “break her water” to try and speed up the labor process. She has no idea what he is talking about and needs an explanation of what the procedure is and why it is necessary. The patient wants to know if it will hurt and if there are any risks involved. How would the nurse answer these questions? Explain this procedure in detail. e) The patient agrees to let the doctor rupture her membranes. There is a gush of clear fluid. What is the nurse’s first response after the membranes are ruptured? What is the priority at this time and what should the nurse be assessing for? f) The patient’s contractions are now coming every 2-3 minutes and they are of moderate to severe intensity. She needs to gather all of her energy to focus on her breathing and trying to relax. The nurse tries to keep the environment as free from stimulation as possible to help her stay focused, calm, and relaxed. Her mother continues to provide comfort measures such as a cool washcloth to her forehead, back rubs and foot rubs, warm clothes to the perineum, and holding her hand during the contractions when needed and helping with her breathing. The patient delivers a baby boy weighing 7 lbs 1 oz. APGARS are 8/9. The baby is immediately given to the mother to promote skin to skin and the nurse wipes the infant dry with a towel and puts a hat on its head. The provider then cuts the umbilical cord. The placenta expulsion occurs 10 minutes after the delivery of the newborn. The mother begins shaking uncontrollably. What stage of labor is the patient now in? How long does this stage of labor last? What is the priority action that the nurse will need to focus on for her during this stage? Explain why the patient is shaking. What 3 hormones are now being released? State the significance of these hormones. Explain the nurse’s actions with the baby in the first hour following birth. What other actions will the nurse do and take right away on the baby? Explain the importance of these actions. do What are the priority nursing diagnoses for this patient? Explain in detail the rationale for choosing these. These can be during or after the delivery. List at least three (3) SCIENCE
******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."
