Guide Questions:

1. What are the reasons for the nurse to transfer Andrea to the Delivery Room? Enumerate the
internal vaginal examination findings and contraction characteristics that will identify that she is
approaching the second stage of labor and delivery.
- Andrea's cervix is already 10 cm fully dilated with her baby's head at station (+1)
- Contractions are closely occurring and labor pains are very intense
2. What are the nurse's responsibilities in preparing Andrea for delivery?
- The nurse on duty transferred Andrea to the delivery table and placed her in a lithotomy
position, put restrain on her arms and placed sterile drapes underneath Andrea.

3. What are effective breathing techniques that Andrea can perform during this time? What is the
purpose of Lamaze breathing? Identify the purposes of the different breathing techniques.

- Cleansing breaths, it allows for increased oxygen to the baby. Internally signal you that a contraction is
beginning and to remind you to begin concentrating on breathing, focusing, and relaxing. Externally
signal your partner and anyone else assisting with the labor that a contraction is beginning.

- Lamaze breathing enhance relaxation and decrease the perception of pain.

4. Identify the effective bearing down techniques that Andrea can perform and give its purposes.

- common technique is to encourage women to take a deep breath at the beginning of a contraction
then hold it and bear down throughout the contraction.

5. Identify the 2 conditions/ procedures that shortened the second stage of labor in the scenario. Give
the purpose of performing these.

6. What are the evidences that will show that Andrea's placenta has separated and is to be delivered.
Give also other conditions that may occur that will identify the separation of the placenta.

7. What are the evidences that will identify that the uterus has contracted? What are the ways!
interventions which will prevent the uterus to become boggy?

8. What are the evidences which will identify that profuse vaginal bleeding/ hemorrhage has occurred?

9. What are the responsibilities of the nurse who is assisting with the delivery?

10. Identify 2 priority nursing problems (nursing diagnoses) of Andrea during the second stage.