NURSING MANAGEMENT DURING LABOR AND DELIVERY SCRIPT

Delivery

Delivery is said to be the make or break moment of a woman’s life. This is the time when the
most precious treasure she has carried for nine months would be saying hello to the world. Prior
to delivery, all preparations must be set, everything must be in its place, and the woman must
know her role in this performance by heart.

-Assessment
Assessment for delivery starts at the second stage of labor, which is the full cervical dilatation
until the birth of the baby. This would be a crucial time since the mother would need to deliver
her baby at this stage without any troubles and with her strength intact so she could push for a
normal vaginal delivery.

-Assess the responses of the mother towards the intensity and duration of the contractions.
-Assess the comfortability of the mother with her birthing position.
-Assess her breathing techniques if they are effective or could add to the difficulty that the
mother might be experiencing.
-Assess the ability of the support person to assist the mother during labor and birth.
-Assess the fetal heart sounds to make sure that there is no occlusion in the cord that could
hinder fetal circulation.
-Assess if the environment is comfortable for both the mother and the baby.

Diagnosis
The difficulties that the mother may encounter during delivery are endless. Not all deliveries
have gone smoothly, so every caregiver must be capable of whipping up a diagnosis and care
plan immediately to assist the mother towards a safe and meaningful delivery.

-Pain related to intensity of uterine contractions

Planning
The place of birth must be prepared prior to delivery.

-For multigravidas, preparation of the room could start when the cervix has dilated to 9 to 10 cm.
-For primiparas, preparation of the birth place should start when the head has crowned to the
size of a quarter.
-The newborn care area must also be prepared within the same room and include supplies for
eye care, suction and resuscitation equipment, radiant heat warmer, sterile towels, and
identification of the newborn.
-The mother should choose a position that will be most comfortable for her during birth.
-Alternative birthing positions today are the dorsal recumbent position, the lateral Sim’s position,
squatting, and semi-sitting.
-A health care provider must be situated at the foot of the birthing table already so that the infant
would not fall off if birth happened precipitously.
Implementation
Now that the care plan is already established, time to take some action and implement those
interventions listed on your cheat sheet.

-Encourage the mother to void before delivery to reduce the discomfort.

-Allow client to take ice chips or hard candies for relief of dry mouth.
-Provide a comfortable environment for both the mother and the baby.
-Allow the client to assume a birthing position of her choice as long as it is not contraindicated.
-Assist the client in venting out any emotions with regards to her delivery experience.

Evaluation
A care plan would not be complete if no evaluation was done to test the effectiveness of the
following:
-Client will be able to manage her discomfort using nonpharmacologic methods.
-Client will be able to identify other pain relief measures.
-Client has no signs of bladder distention and can void every 2 hours.
-Client states that she has reduced or no mouth discomfort.
-Client states that the environment is comfortable enough.
-Client reports that the delivery is a tolerable and highly meaningful part of her life.

Nothing could ever make our hearts glow than seeing and cradling our own bundle of flesh and
blood for the first time. A woman will indeed feel the fullness and completeness of her life once
she bore children and the realization that they have grown inside of her because she nourished
them will last for the entirety of her lifetime and inspire her every day of her life.

LABOR

According to this site, patients with precipitous labor revolves around promoting maternal and
fetal well-being, prevention of complications, and providing a safe delivery.
During labor , I will be discussing the possible diagnosis and its nursing management.
Risk for Deficient Fluid Volume
-Note client’s level of consciousness and mentation
-Monitor intake and output balance.
-Monitor vital signs.
-Encourage oral intake
-Provide supplemental fluids as indicated
-Administer medications as indicated.
-Review appropriate use of medications.
Anxiety
-Maintain a calm, deliberate manner. Offer clear and concise instructions. Provide explanations
-Provide a quiet environment and privacy within parameters of the situation. Position client for
optimal comfort.
-Encourage partner or SO to remain with the client, provide support and assistance as needed.
-Remain with the client. Provide ongoing information regarding labor progression and
anticipated delivery.
-Encourage appropriate coping or relaxation techniques.
-Arrange for services of medical or nursing staff as soon as possible. Inform client that help has
been requested.
-Conduct delivery in a calm manner; provide ongoing explanation.
-Place newborn on maternal abdomen once newborn respirations are established. Allow partner
to hold infant.
-Administer sedation as appropriate

Risk for Infection

-Observe for localized signs of infection at the wound
-Stress proper hand hygiene by all caregivers between therapies and clients.
-Recommend routine or preoperative body scrubs or showers when indicated
-Maintain sterile technique for all invasive procedures.
-Cover perineal dressings with plastic when using bedpan
-Administer/monitor medication regimen and note client’s response.
-Emphasize necessity of taking antibiotics as directed.
-Discuss importance of not taking antibiotics or using leftover drugs unless specifically
instructed by healthcare provider.

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