MEDizzy - A laboring client smiles pleasantly at the nurse when asked

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The Multigravid Client in Labor

A laboring client smiles pleasantly at the nurse when asked simple questions. The client speaks no English and the interpreter is busy with an emergency situation. At her last vaginal examination, the client was 5 cm dilated, 100% effaced, and at 0 station. While working with this client, which of the following responses indicates that the client may be approaching delivery?

ExplanationWhen the fetal head is compressed, early decelerations are seen as a vagal response occurs and the fetal heart rate decelerates and inversely mirrors the contraction. This response commonly occurs when the client is 9 to 10 cm dilated or push- ing. If communication cannot be facilitated, early decelerations are one indicator that delivery may be approaching. Late decelerations may occur at this time but indicate uteroplacental insuffi ciency rather than imminent birth. At any time during the labor process, the client may communicate with her fam- ily in her native language. The client’s facial expres- sions may change at any point during labor and cannot be used as an indicator of imminent delivery.