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Marvis is a 29-year-old G1 P0 in labor at 40 weeks of gestation. She was admitted at 0200 with a history of contractions since 2200 the night before. On admission she denied spontaneous rupture of membranes or vaginal bleeding. She felt good fetal movement. Her vital signs and the fetal heart rate were normal. Her contractions were every 6 minutes and lasting 30 seconds. Her cervical examination was 2 cm/70%/−2 vertex. It is now 0600 and she has been reexamined. Her cervical examination is now 3 cm/90%/−2 vertex. Her contractions are now every 4 to 5 minutes lasting 60 seconds. She states they are still mild. Marvis has stated that she wants a natural unmedicated birth.

1. In what stage of labor is Marvis?

2. Marvis expresses disappointment in her progress.
   What can the nurse do to help her at this point in labor?

3. It is now 1000 and Marvis states the contractions have become much stronger. She now needs to use breathing techniques to cope with the contractions. She declines pain medication. Her cervical examination is now 5/100/0. What stage of labor is Marvis in at this time?

4. What nursing care is indicated at this phase of labor?

5. Marvis is now perspiring profusely and shaky. She feels she can’t cope any longer. She pushes away her husband as he tries to rub her back. An increased amount of bloody show is present. She also reports a gush of fluid. Even without a cervical examination, what phase of labor is Marvis most likely in?

6. A cervical examination at 1300 confirms the transition phase as Marvis is 8/100/0 station with spontaneous rupture of membranes with clear fluid. What nursing care is indicated at this time?

7. Marvis managed to cope well through transition by going into the shower. She now reports an urge to push. A cervical examination at 1600 reveals that Marvis is still 8/100/0. Fetal heart rate is normal, and maternal vital signs are normal. She is distraught at her lack of progress and states she cannot do it anymore. What nursing care is appropriate at this time?

8. Nursing assessment reveals an abdominal mass just above the symphysis pubis. What is a likely explanation, and what should be done?

Answer 1

1. In what stage of labor is Marvis?

Marvis is the latent / early phase of labour in stage one. Latent / early labor is mainly characterized by a consistent pattern of increasing frequency duration of contractions and the occurrence of cervix erasing and/or dilation.

2. Marvis expresses disappointment in her progress. What can the nurse do to help her at this point in labor?

It is the responsibility of the Nurse at this juncture to educate Marvis that at this time the progress of her labor is slow as it is in the latent state the average duration of nullipara is 7.5 to 8.5 h. During this period, the nurse can also support her by offering touch and comfort. This process assists the laboring mother with both physical and emotional support.

3. It is now 1000 and Marvis states the contractions have become much stronger. She now needs to use breathing techniques to cope with the contractions. She declines pain medication. Her cervical examination is now 5/100/0. What stage of labor is Marvis in at this time?

Marvin is in phase one only but is currently in Active Stage. The active stage is characterized by a more rapid dilation of the cervix (between 4 cm and 6 cm), an increase in discomfort / pain as the pace of labor increases, and contractions occur every 3 to 4 minutes and typically last between 40 and 60 seconds.

4. What nursing care is indicated at this phase of labor?

In this process of labor, the specified nursing care helps the laboring mother to relax and be relaxed, provide pain medication, and provide certain methods of pain relief, such as imaging. The nurse might offer to cool her face with a back rub or a wet washcloth. If the patient has a mentor in the room or a partner will help by asking their needs and what to do to help the process.

5. Marvis is now perspiring profusely and shaky. She feels she can’t cope any longer. She pushes away her husband as he tries to rub her back. An increased amount of bloody show is present. She also reports a gush of fluid. Even without a cervical examination, what phase of labor is Marvis most likely in?

· Marvis in now in transition phase of second stage of labor. This stage begins withcomplete 10 cm dilation and full 100% effacement of the cervix and ends with the birth of a baby.

· Contractions are very strong, usually 60 to 90 seconds long and the peaks are intense. The laboring patient senses intense pressure as the fetus descends, similar to an urge to have a bowel movement.

· Women 's behaviour at this stage involves feeling nervous, irritable, powerless as the contraction intensifies, the woman may weep or scream in pain, and most typically people will neglect any relaxation or calming techniques.

6. A cervical examination at 1300 confirms the transition phase as Marvis is 8/100/0 station with spontaneous rupture of membranes with clear fluid. What nursing care is indicated at this time?

- Rubbing on back
- Warm compressing
- bath
- Breathing and relaxation excercises
- Music therapy
- Involving the partner for his support
- Providing continuous labor support

7. Marvis managed to cope well through transition by going into the shower. She now reports an urge to push. A cervical examination at 1600 reveals that Marvis is still 8/100/0. Fetal heart rate is normal, and maternal vital signs are normal. She is distraught at her lack of progress and states she cannot do it anymore. What nursing care is appropriate at this time?

Specific pain management strategies will be discussed. Second, according to the patient's request, no pharmacological treatments should be provided. Depending on the patient 's distress, considering both risk and benefit, the pharmacological interventions may have to be pursued. The nurse needs to have access to the fetus' wellbeing and monitor the mother's vital signs. The patient has to be encouraged to simultaneously push and breathe deeply without holding the breath for more than five seconds. It takes all of the patient's strength, energy and will to do this and motivating the patient goes a long way to delivering the baby well.

8. Nursing assessment reveals an abdominal mass just above the symphysis pubis. What is a likely explanation, and what should be done?

The abdominal mass is an inflammation which causes varying degrees of pelvic and abdominal pain in various patients. We highly recommend therapy sessions aimed at relaxing, strengthening, medicating and stabilizing the muscles around the symphysis pubis.