Question

CASE STUDY 3

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?

   
   

Answer 1

1- Marvis is in first stage of labor (latent phase) . Her cervix is dilated 3 cm with 90% effacement of cervix and vertex at -2 station . Her contractions is also mild at 0600 .

2- deep breathing and active to maximize contractions.

3- Marvis is now at first stage of labor (active phase - phase of maximum slope)

4- Deep breathing followed by slow - pace rhythmic breathing.  

5- Marvis is in first stage of labour as cervix is not fully dilated and there is rupture of membrane.