Part One: Nursing Care
- In what stage of labor is Marvis? Marvis is in the early labor. It is characterized by effacement (thinning) and dilation (opening) of the cervix. This is evident from the gradual increase in the size of her cervix and the duration the contractions take. They moved from occurring after every six minutes to between four and five minutes lasting 30 and 60 seconds respectively.
- Marvis expresses disappointment in her progress. What can the nurse do to help her at this point in labor? The nurse can engage her in usual activities that can help her relax. The nurse should make sure that Marvis has enough rest and give her clear fluids like water to drink. By doing this, Marvis’s contractions may go away for some time due to a change in activity. However, the change in activities is temporary, as the contractions will become stronger over time when she advances to the next stage.
- 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? Marvis is in active labor
- What nursing care is indicated at this phase of labor? The use of slow, easy breathing is helpful at this stage as it helps on maximizing the composer to deal fully with the contractions. Less talk is also advised to allow the patient have more time and become involved with the contractions. Using relaxing images, music, and focusing on relaxing in between the contractions saves the patient some much-needed energy in the labor progress. It also helps with the gradual opening of the cervix. Massage, changing positions, standing, walking, sitting upright and relaxing in whirlpools or soaking tubs ease discomfort and relaxes the patient.
- Marvis is now perspiring profusely and shaky. She feels she cannot 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? She is in the transitional phase to the second stage of labor
- 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? The most effective form of care during this stage is the use of easy controlled breathing mechanism. It allows the cervix to thin and dilate evenly and saves the patient energy needed to push. At times, uneven breathing patterns also works at this phase.
- 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? The nurse needs to access the well-being of the fetus and monitor the vital signs of the mother. The patient needs to be encouraged to push and breathe deeply at the same time without holding the breath for more than five seconds. It takes a lot of power, energy and will of the patient to do this and encouraging the patient goes a long way to delivering the baby well.
- 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 that causes pelvic and abdominal pain of varying degrees in different patients. Therapy sessions that are aimed at stretching, strengthening, medicating, and stabilizing the muscles around the symphysis pubis are highly recommended.
Part Two: Differing Parenting
1) What can the nurse do to help this couple? The nurse needs to review the parenting styles used for the couples, then pinpoint areas of interest, such as decision-making, caretaking, discipline, show of love, nurturing, and activities participation. The nurse needs to talk to the couple about the areas they are comfortable taking part, and combining effort for the good of their child. From there, the couple will find a leveled ground to comfortably parent their child with little issues.
2) What specific interventions may be helpful? The couple may also need to seek help from professionals, including a pediatrician and a marriage counselor. The two professionals will help them as they are well vast in handling such cases, and knowledgeable in matters concerning parenting. They will advise the couple accordingly.
3) How can Joel’s family help? Joel’s family can advise Joe’s wife on how to get along with the newborn baby. They can use their hospitable nature to become a stepping-stone towards Lisette’s shortcomings from her past and take her into a good phase of effective parenting through practical living.
4) What other resources are important for this family? Seeking online help on literature that support effective parenting, e