Stage of Labor Evaluation and Recognizing Vaginal Findings and Equating Nursing Intervention

Stage of Labor Evaluation and Recognizing Vaginal Findings and Equating Nursing Intervention

Based on the vaginal evaluation findings, Desiree is in the second labor phase, the pushing stage. The cervical dilation of ten centimeters indicates that her cervix is fully dilated, while a hundred percent effacement suggests that the cervix has thinned out fully. The positive one station indicates that the baby’s head is subsided into the pelvis and is approximately one centimeter above the ischial spines. In this phase, the nurse must motivate Desiree to start pushing with each contraction to assist in facilitating the baby’s descent through the birth canal. The nurse must offer directions on effectual pushing methods like deep breathing, utilizing the abdominal muscles, and pushing during contraction. The nurse must also continuously observe the fetal heart rate to ensure it remains encouraging. The nurse needs to develop a supportive and reassuring environment for Desiree during this phase. The nurse should provide emotional support, offer encouragement, and praise her efforts. Position changes like squatting or side-lying may be advocated to help in the baby’s descent and offer comfort for Desiree. The nurse is also responsible for preparing for the imminent birth by ensuring that all appropriate tools and supplies are readily available. This involves setting up the delivery table, collecting sterile instruments, and ensuring the availability of emergency tools in case of any unexpected complications. The nurse must be prepared to offer immediate newborn care once the baby is delivered, involving drying and stimulating the newborn, initiating skin-to-skin contact, and evaluating the baby’s initial respiratory effort and overall condition. Comprehensively, the nurse’s role throughout the second phase is to support Desiree physically and emotionally, foster effectual pushing methods, observe fetal well-being, and prepare for the baby’s birth.

Evaluation of External Fetal Monitor Fitness for Desiree and Consideration for Transitioning to Internal Monitoring During Labor

The nurse determined that the external fetal monitor would suit Desiree based on numerous factors. Desiree is considered low risk, as highlighted by her personal and family health history, physical assessment, and development of pregnancy without complications. This indicates that the likelihood of fetal distress or complications throughout labor is relatively low. In addition, Desiree’s birth plan highlights a preference for natural childbirth without pharmacological intervention, indicating that she deserves minimal medical interventions unless needed. The external fetal monitoring offers progressive observation of the fetal heart and uterine contraction, permitting the healthcare team to assess the fetus’s well-being and recognize any signs of distress (Yang et al., 2021). In Desiree’s case, the monitor suggests a favorable fetal rate of 130 beats per minute, indicating that the baby is abiding labor well. Since Desiree’s labor is continuing smoothly, her vital signs are stable, and there are no indicators of fetal distress, the external fetal monitoring is suitable for observing the progress of labor and the well-being of both the mother and the baby.

Moreover, certain factors may constrain a change to internal fetal monitoring throughout labor. If any concerns develop regarding the fetal well-being, like abnormal fetal heart rate sequences or signs of distress, the healthcare provider may go for internal monitoring. In addition, if the external monitor becomes undependable because of factors like maternal movement or obesity, it may be appropriate to switch to internal monitoring for more precise readings. Other indications for internal monitoring include the need for accurate measurement of uterine contractions, evaluation of fetal scalp blood pH, or if the membranes have not fractured (Gibb & Arulkumaran, 2023). The healthcare provider creates the decision to switch to internal monitoring based on the specific situations and the need for more detailed and precise information about fetal well-being during labor.

Respond to Desiree Considering her Birth Plan, Stage of Labor, and Assessment Data

One would respond to Desiree by recognizing her concerns and providing reassurance and support. One would say, Desiree, I comprehend that the pain can be intense during labor, and it is normal to feel overwhelmed at this phase. You have done a fantastic job and are continuing well in your labor. Recall that your birth plan reflects your preference for logical childbirth with no pharmacological interventions, and here we are to support you in achieving that. You have taken part in childbirth education classes, providing numerous coping mechanisms and methods to manage the pain. We encourage you to attempt distinct positions, relaxation methods, and breathing exercises that