1st Stage Labor

Harpreet Patel is a 30 year old female who is 39 weeks pregnant and is now in active labor. She is worried about the health of her baby. This is her first pregnancy and just hopes everything goes well.

Inpatient Hospital Room

1. Assess maternal and fetal well-being during the first stage of labor, including contraction pattern, cervical dilation, fetal heart rate (FHR), and maternal coping.
2. Perform focused assessments, including Leopold’s maneuvers, fetal monitoring interpretation, vital signs, pain level, and emotional state.
3. Identify the phase of labor (latent, active, or transition) and respond with appropriate nursing interventions.
4. Implement comfort measures and coping strategies, such as position changes, breathing techniques, and non-pharmacological pain management.
5. Administer medications as ordered using the rights of medication
6. Communicate effectively with the patient and their support person, using therapeutic techniques to reduce anxiety and promote trust.

1. Identify the current phase of labor based on cervical changes, contraction pattern, and maternal behavior.
2. Accurately assess and interpret fetal heart rate patterns using intermittent or continuous monitoring.
3. Support the laboring patient using verbal encouragement, comfort strategies, and evidence-based interventions.
4. Administer labor-related medications and monitor for effects or complications.
5. Communicate findings to the provider using SBAR and participate in shared decision-making with the patient.
6. Document labor progression, interventions, and patient response in the medical record thoroughly and clearly.