What are the recommendations during the active phase?

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Expert Solution

Active Phase

-contractions become more frequent (every 3-5 minutes) lasting 60 seconds, moderate to severe

-woman becomes more focused on each contraction and tends to draw and inward attempt to cope with increasing demands of labor

- 4 to 7 cm dilated

-increased anxiety and discomforts, unwilling to be left alone

-Slight flush over face. Respirations deepen.

-Avg length 4.6 hrs primips, 2.4 hrs multips

-Assess and note color of vaginal secretions, IV therapy PRN. If epidural: IV hydration & monitor BP q 1-2 min x 15 min, then q 10-15 min til stable.

-Check vital signs q 15-60 min. Assess contractions q 5-15 min. Encourage voiding q 2 hr & assess for bladder distention if unable to void.

-Encourage shallow breathing or modified paced. Try to keep breathing rate no more than 16 bpm to prevent hyperventilation. Slow & rapid breathing may be combined (more rapid used at height of contraction)

-Contractions radiating to front with added pressure in groin as baby moves into pelvis. Backache may be increased.

-Fatigue becomes a factor. More dependent on coach. Needs encouragement, reassurance, praise. Change positions. Encourage relaxation bt contractions. Cool cloths for face, back rubs, massage, hot/cold packs for lower back, offer ice chips.

-Preoccupied with self and labor. Desire for companionship increases. Doubts about progress in labor & ability to cope may begin.

Nightingale answered 1 year ago

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