During the call, the nurse can determine whether Emily is having true or false labor with several inquiries. The nurse should ask about the estimated date of birth, fetal movement, other premonitory signs of labor, previous childbirth experiences, and a description of the contractions, such as frequency, duration, and intensity. The nurse would ask Emily to observe her own body for any vaginal bloody shows or ruptured membrane. In the end, the nurse would inquire if Emily has any adult able to provide support at home. Upon arrival, the nurse would ask Emily for a urine sample to analyze the proteins, sugars, and ketones.
The nurse can determine that this is Emily’s first pregnancy. According to TPAL terminology, she had no previous term or preterm births, abortions, or living children. Labor can begin at 39 weeks of pregnancy and some signs include diarrhea, loss of the mucus plug, water breaking of different severity, and cervical effacement (Murray, 2020). Emily’s contractions should move from the front of her body to her uterus if she is currently in labor. On the psychological side, Emily’s talkative attitude is a sign of excitement, which is normal, though she may begin to feel nervousness and tiredness as well.
It is suggested that Emily continues to track the baby’s kick counts, keep taking prenatal vitamins, get suitable amounts of sleep, minimal movement like walking or simple stretching exercises. The baby’s kicks will decrease closer to labor but should not stop, and vitamins are essential even throughout breastfeeding. Mild exercise can help ease aches and keep the mother flexible which can help during the delivery process. After Emily informs the nurse that she feels wetness, a doctor or nurse should provide a physical exam to determine whether the leakage is urine or amniotic fluid. In some situations, an ultrasound may determine amniotic fluid volume.
The five factors that influence the pain should be determined. The position and size of the baby, the passage or birth canal, the contractions, the placenta, and the current mental and emotional well-being of the mother. Diane is experiencing back pain while in labor, which is likely caused by the occiput posterior position of the baby. This means that the baby is facing downwards but with its face looking up at the stomach instead of the mother’s back. Diane is only 30% effaced at 3cm though she should be 100% effaced with a 10cm dilation at this stage of labor. This can slow down the process of labor considerably. The nurse can offer Diane an epidural, pain relief options, and alternate sensations of heat and cold to soothe the pain.
Reference
Murray, M., L., & Huelsmann, G. (2020). Labor and delivery nursing (2nd ed.). Springer Publishing Company.