Desiree, a 28-year-old G2P1, is admitted to the labor and birth unit due to contractions. Her birth plan indicates that

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answerhappygod
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Desiree, a 28-year-old G2P1, is admitted to the labor and birth unit due to contractions. Her birth plan indicates that

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Desiree, a 28-year-old G2P1, is admitted to the labor and birth
unit due to contractions. Her birth plan indicates that she is
planning natural childbirth without pharmacological interventions.
She has attended childbirth education classes. Desiree is
considered low-risk based on her personal and family health history
and physical exam. Her pregnancy has progressed without
complications. She is approximately 39 weeks pregnant. Pertinent
labs are as follows: O positive, rubella immune, GBS (group beta
strep) negative, hemoglobin 11.2. Vaginal assessment reveals
cervical dilation at 5 cm, 80% effaced, and -1 station. Her
membranes are intact. After a few hours Desiree has spontaneous
rupture of membranes with large amount of clear fluid. She begins
to get very restless and anxious. Desiree wants to take off the
fetal monitors and move. She is having a hard time remaining
focused during contractions and she is irritable. The baseline
fetal heart rate is 130 beats per minute, moderate variability,
accelerations, no decelerations. Contractions are every 3 minutes,
lasting 60-70 seconds, with strong intensity.
4. What nursing actions should you perform and why?
5. What phase of labor do you suspect Desiree is in and why?
6. What would you say to Desiree to give her emotional support?
How would you explain the phase of labor she is in to her and her
partner?
7. Discuss three maternal and/or fetal danger signs in labor.
Include what the danger sign is and what nursing intervention would
be required to monitor for the identified danger sign?
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