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During prenatal visits,
patient learns to come to birthing unit
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1.ROM
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2.Regular, frequent contractions (nullipara- 5 mins apart, multiparas –
10 – 15 mins apart x1hr
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3.Vaginal bleeding.
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Admission process influences
the course of hospital stay. Refer to Teaching About… p 358
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Nursing management:1st
stage:
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Assist to bed; side-lying
position; obtain admission data; collect clean ureing speciman; dipstick
urine for presence of protein, glucose, ketones ; draw labs for Hct, Hgb,
T&C, serological testing per institution policy; signed informed consent
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Provide education
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Family expectations –
emotional support, comfort measures, advocacy for dreams for birth
experience; praise for efforts.
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Integration of cultural
beliefs: knowledge of values, customs, and practices is vital in L&D.
Modesty issues (males present, Asian cultures); Middle East countries
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Pain expression: quiet or
vocal; some “keen” and wail. Depends on culture. Concept of hot and cold foods & water.
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Pain: physiologic
manifestations : ↑ pulse & resp; dilated pupils, ↑ BP, &
muscle tension. Women often tighten skeletal muscles and lie motionless
→ muscular tension.
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Latent: pt is usually happy
& eager; establish rapport; offer fluids; comfort measures
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Active : feelings of helplessness, abandonment; enc
maintaining breath patterns; comfort rubs, keep couple informed
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Transition: restless, tired,
irritable; feels out of control; enc her to rest between contractions;
promote comfort; some women don’t want to be touched; ice chips, privacy
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REFER TO TABLE 17-2: P 367
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