Reference no: EM133948741
Case Study Overview
Xiao is a nulliparous woman at 39 weeks' gestation. She and her husband Ni attended childbirth education classes based on the Lamaze method. They also prepared a birth plan with their nurse midwife. Xiao calls her nurse midwife's office to report that she is in labor and asks if she should get her husband and leave for the hospital right away.
Questions
1. Xiao becomes tense and begins to cry when the nurse prepares to perform a vaginal examination as part of the admission process? What should the nurse do?
2. A priority nursing diagnosis for Xiao would be: Acute pain related to the increasing frequency, duration, and intensity of uterine contractions during the first stage of labor. State one expected outcome and discuss the non-pharmacologic measures the nurse could use to help reduce Xiao's pain and discomfort.
3. Xiao is reluctant to get out of bed or to change her position (semi-Fowler) in bed. She states that she feels just fine the way she is. What approach could the nurse take to help Xiao realize the importance of remaining active for as long as possible and of changing positions frequently throughout labor?
4. Xiao and Ni have become moderately anxious as labor begins to slow. What measures could the nurse use to enhance and facilitate the progress of Xiao's labor?
5. Xiao is now in active labor. Ni appears more and more anxious as Xiao's labor advances, especially when she has a contraction and her reaction to the pain becomes more evident. It is obvious he is losing confidence in his ability to help Xiao as she becomes less responsive to his coaching efforts. What can the nurse do to help Ni regain his confidence and composure?
6. Because Xiao is in the active phase, ongoing assessment of her status, fetal well-being, and progress of labor becomes more critical. Outline the components of this ongoing assessment, the recommended frequency during the active phase, and the expected findings.
7. Xiao and Ni included the option of epidural anesthesia in their birth plan. When Xiao reaches 5 cm, they request that the epidural anesthesia be administered if it would be safe for both Xiao and the baby.
8. What assessment data should be gathered before the induction of the anesthesia and during its administration?
9. How should the nurse support Xiao and Ni just before and during the induction?
10. What nursing measures should be implemented to ensure the safety of Xiao and the fetus after the epidural anesthesia is administered?
11. What nursing measures should be implemented to ensure the safety of Xiao and the fetus after the epidural administration?