A patient having her fourth child is admitted to the labor unit ...

[dalyningkenk]

A patient having her fourth child is admitted to the labor unit and is accompanied by a doula. The intrapartum nurse expects the doula to assist with:
 
  1. Fetal monitoring and relaxation techniques.
  2. Physical and emotional comfort techniques.
  3. Breathing techniques and labor assessment.
  4. Massage and vaginal exams.

Question 2

The labor and delivery nurse is reviewing charts. The nurse should inform the supervisor about which patient?
 
  1. Multip at 5 cm requesting labor epidural analgesia
  2. Primip whose cervix remains at 6 cm for 4 hours
  3. Multip who has developed nausea and vomiting
  4. Primip requesting her partner to stay with her

[aprice35067]

Answer to Question 1

2
Rationale 1: The doula will not be involved with fetal monitoring.
Rationale 2: A doula is a trained lay birth companion, and focuses on helping the mother to relax and increase her comfort.
Rationale 3: The doula does not do labor assessments.
Rationale 4: A doula does not do vaginal exams.

Answer to Question 2

2
Rationale 1: Contacting the supervisor is required when an abnormal situation is present. A multip requesting an epidural at 5 cm is not abnormal.
Rationale 2: Average cervical change among primips in the active phase of the first stage of labor is 1.2 cm/hour; thus, this patient's lack of cervical change is unexpected, and should be reported to the supervisor.
Rationale 3: Nausea and vomiting are common during the transitional phase of the first stage of labor. Contacting the supervisor is required only when an abnormal situation is present.
Rationale 4: Patients in the transitional phase of the first stage of labor often fear being left alone; this is an expected finding. Contacting the supervisor is required only when an abnormal situation is present.