Client was a 32 year old female at 37 weeks gestation at the hospital for a vaginal delivery. This was her first pregnancy therefore she was gravidity 1, parity 0. Her entire GTPAL would be G1T0P0A0L0 because she did not have any previous pregnancies, term births, preterm births, abortions or living children. After delivery her GTPAL was be G1T1P0A0L1.
Client began pushing at 0600 and was at stage 2 when observation started at 0700. Cervical dilation and effacement had already started to occur and she was dilated to 10 cm. She was in this stage for about an hour. This stage takes longer for nulliparous women than multiparous women. This stage has two phases: the latent and active phase. The woman pushes and bears down during the contractions in the active phase. The fetal heart rate dropped below 100 bpm during this active phase when client pushed. Because of this, client pushed every other contraction to allow the baby's heart rate to go back up and give the mother time to rest.
The main goal of the nurse assisting with labor and delivery is to provide support, establish a therapeutic relationships and advocate for the client. The initial assessment was already completed prior to the observation. During this initial assessment the nurse would want to make the client and family feel welcome, determine expectations about birth, convey confidence in the client and respect any cultural values. Initial assessment would also include prenatal care information, past medical history, status of labor, and physical assessment. Observation because during second stage of labor. When first entering the room the nurse introduced herself and did bedside report with nurse she was relieving. After report the nurse assessed the psychosocial status of the client and used therapeutic touch to encourage relaxation. The nurse assessed the monitors continually for dips in FHR, and contraction and bearing-down effort. Because the nurse assessed that the FHR dropped during...
References: Wilson, D. (2012). Birthing Traditions in Tibetan Culture. International Journal Of Childbirth Education, 27(1), 33-38.
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