Nursing Management of First Stage of Labour:
Place of delivery: All women, ideally, should be delivered in hospital. The objective in the rural areas should be to hospitalize the high risk pregnancies. The mothers in the low risk group may be delivered at home by rained birth attendants (TBA). In the below, I have presented the nursing management of first stage of labour.
1. Admission in hospital generally the patients are asked to admit when the pain starts.
2. Maintenance of hygiene:
- Shaving of the vulva and wash with soap and water,
- Wearing of clean loose garments,
- Encouragement and assurance,
- Constant supervision.
3. Rest: Patent can walk if membrane is intact.
4. Diet:
- Liquid diets, food and oral fluids should be withheld as soon as active labour is established.
- If necessary nutrition can be maintained by IV fluid.
5. Care of bowel: Low enema simplex should be given to empty the bowel.
6. Care of bladder: The patient should be encouraged to pass urine by self micturation, if failed catheterization is to be done.
7. Analgesics or pain relief: If untolerable inj. (pethidne 50-100 mg IM (Pethidine is to be given when at least the cervix is 3 cm dilated).
8. Maternal monitoring:
- Vital sign,
- Dehydration,
- Urinary output,
- Urinary protein and acetone.
9. Fetal monitoring:
- Fetal heart rate
- Color of the liquor
- Fetal movement
- Degree of moulding
- Caput formation
10. Assessment of Progression of labour:
a. Abdominal examination: this should include the following points-
Uterine contraction:
- Number of contraction in 10 minutes,
- Duration of each contraction- in second.
Decent of fetal head in fifths is to be determined.
Shifted of fetal heart sound downwards medially.
b. Vaginal examination: Done at 4 hourly intervals.
- Dilatation of the cervix and effacement,
- Position and degree of flexion of the head,
- Caput and degree of moulding,
- Station of the head in relation to ischial spines.
Nursing interventions of First Stage of Labour:
Care of the woman during the first stage includes-
- Reduce anxiety and offer assistance,
- Do not interrupt breathing during contractions,
- Promote change of positions,
- Encourage voiding and promote bladder care,
- Encourage client to suck on hard candy, ice chips,
- Apply cream on dry lips of client,
- Administer IV solution in case of DHN,
- When hyperventilating, keep paper bag nearby and teach on how to use it.
More questions related to this article:
- Describe the management of first stage of labor.
- How to manage first stage of labor?
- How will you manage first stage of labor?
- Describe the nursing interventions of first stage of labor?
- Describe the nursing diagnosis of first stage of labor.
- Describe first stage of labor nursing interventions.
Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”