QUESTION: "A pregnant client's husband coaches her with breathing and relaxation techniques as they were taught in childbirth preparation classes. When the client reaches the transition phase of labor, she screams out, "I can't do this anymore!" Which of the following suggestions would be most helpful for the client's husband?"
CHOICES
( X ) a.) "Let me take over the coaching for a while."
( X ) b.) "Ask your wife if she wants anesthesia."
( X ) c.) "Tell your wife that it will be over soon."
( O ) d.) "Maintain direct eye contact and breathe with her."
RATIONALE: The transition stage of labor requires reinforcement of techniques learned during preparation for childbirth classes. It is best when the husband speaks to his wife using direct eye contact and breathes with her when she loses control during the transition stage. This often helps her regain control. The client should be encouraged to focus on one contraction at a time at this point in labor. Telling the husband that he should allow the nurse to take over the coaching is not appropriate. It diminishes his role and may instill feelings of failure. When the client reaches transition, or 8 to 10 cm of dilation, it is usually too late for anesthesia. The client will soon need to expel the fetus. Anesthesia at this point may cause respiratory depression in the neonate. Telling the husband to let the client know that it will soon be over does not help her gain control. This type of response is placating and is not helpful for the client. NURSING PROCESS STEP: Implementation CLIENT NEEDS CATEGORY: Psychosocial integrity CLIENT NEEDS SUBCATEGORY: None
