Labor and Deliver

Mrs. Main. is a 27-y/o gravida 3, para 2, who was admitted at term at 6:30 p.m. She stated that she had been having contractions 7 to 10 minutes apart since 4 p.m. They last 30 seconds. She also stated that she had been having “a lot of false labor” and hoped that this was “the real thing”. Her membranes are intact. Mrs. Main’s temperature, pulse and respirations are normal, and her blood pressure is 124/80. The fetal heart tones are 134 and regular. Mrs. Main vaginal exam is 4/ 80%/ +1 She reported her findings to the doctor and he ordered Fentanyl 50 mcg every hour as needed for pain.
1. In the information provided, do you think Mrs. Main is in true or false labor? Give reasons to support your answer.
2. As Mrs. Main was getting into bed, her membranes ruptured. What is the first thing that should be done when this occurs? Why?
3. After her membranes ruptured, her contractions began coming every 4 minutes and lasted 45 to 55 seconds. They were moderately strong. Why is it important to relax during her contractions? How can you help her with this?
4. When would it be appropriate to give her the Fentanyl the doctor ordered? What safety measures should be taken at the time the medication is given? Also, at what point is it unsafe to give the medication to her and why?


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