Emily, age 32, has an obstetrical history of G1, T0, P0, A0, L0. Emily’s week of gestation is 39.1. Emily telephones the health care provider’s office and tells the nurse she believes she is in labor. Based on her assessment, the nurse advises her to have her husband bring her to the labor and birth unit. Emily arrives and is admitted. She is talkative and excited about being in labor and describes her contractions and discomfort as mild. The following are the assessment findings of the examining nurse: Maternal vital signs are stable. Fetal heart tones with the external fetal monitor are reassuring. Vaginal exam indicates the cervix is 3 cm dilated, 40% effaced, membranes intact with the presenting part engaged. Ten minutes after the vaginal exam by the nurse, Emily says, "I think I just wet my pants." 1. What questions might the nurse have asked Emily to determine that she may be in true labor? What prenatal history information should the nurse have obtained during the telephone call?
2. Explain the meaning of the nurse's assessment findings. Identify the stage and phase of labor, listing the physiologic and psychological changes during this stage. What positions and activities would be appropriate for Emily based on the assessment data? Why?
3. Describe the nursing interventions that would be appropriate for the nurse to implement based on Emily's statement that "I think I just wet my pants." 2. Diane, age 22, has been in labor for 8 hours. Her cervical exam reveals she is 3 cm, 30% effaced and -1 station. Diane has been feeling most of her pain in her lower back.
1. Given your understanding of the 5 P's and the cardinal movements of labor, discuss why Diane is having back labor and why her progress is slow.
2. What strategies may the nurse implement to assist Diane in progressing in her labor?