Physiological Integrity Q 34
A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:
A. Her contractions are 2 minutes apart.
B. She has back pain and a bloody discharge.
C. She experiences abdominal pain and frequent urination.
D. Her contractions are 5 minutes apart.
Correct Answer: D. Her contractions are 5 minutes apart.
The client should be advised to come to the labor and delivery unit when the contractions are every 5 minutes and consistent. She should also be told to report to the hospital if she experiences rupture of membranes or extreme bleeding. True labor consists of contractions at regular intervals. As labor progresses, these contractions become stronger, and the time between each contraction decreases.
Option A: She should not wait until the contractions are every 2 minutes. The first stage of labor is divided into two phases, which are defined by the degree of cervical dilation. The latent phase is during the dilation from 0 to 6 cm, while the active phase starts from 6 cm to full cervical dilation of 10 cm.
Option B: The woman should not wait until she has a bloody discharge. It is essential to call the healthcare provider at any time if there is bright red vaginal bleeding; continuous leaking of fluid or wetness, or if your water breaks (can be felt as a “gushing” of fluid); strong contractions every five minutes for one hour; and contractions that the woman is unable to “walk through”.
Option C: Has a vague answer and can be related to a urinary tract infection. The way a contraction feels is different for each woman and might feel different from one pregnancy to the next. Labor contractions cause discomfort or a dull ache in your back and lower abdomen, along with pressure in the pelvis. Some women might also feel pain in their sides and thighs. Some women describe contractions as strong menstrual cramps, while others describe them as strong waves that feel like diarrhea cramps.