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Coping with Labor Algorithm V2 ©

Observe  for  cues  on  admission  and  throughout  labor.   Legend  


Assessment  per  protocol:     [S]  =  Sufficient  Evidence  
ƐŬ͗͞,ŽǁĂƌĞLJŽƵĐŽƉŝŶŐǁŝƚŚLJŽƵƌůĂďŽƌ͍͟  
  [L]  =  Limited  Evidence  
™Every  shift  ™  PRN  ™  At  signs  of  change.     [I]  =  Insufficient  Evidence    
[*]  =  No  Evidence  &  No Harm

Coping Not Coping

Cues  you  might  see  if  woman  is  coping:   Clues  you  might  see  if  woman  is  NOT  coping    
  (May  be  seen  in  transition)  
 
States  she  is  coping  
States  she  is  not  coping  
Rhythmic  activity  during   Crying  (May  see  with  self-­‐hypnosis)  
contraction  (Rocking,  swaying)   Sweaty  
Focused  inward   Tremulous  voice  
Rhythmic  breathing   Thrashing,  wincing,  writhing  
Able  to  relax  between   Inability  to  focus  or  concentrate  
contractions   Clawing,  biting  
Vocalization  (moaning,  counting,   Panicked  activity  during  contractions  
chanting)   Tense  

Physiologic. Natural Physical Environment Emotional/ Psychosocial


process of labor

Patient desires Appropriate changes to


Patient desires non- environment PRN [S] One-on-One Support [S]
pharmacological pharmacological intervention Doula [S]
intervention Midwifery Care being
Mood [*]
Lighting [*] ³:LWK:RPDQ´>6]
Music [*]
Interventions as to what would Fragrance [*]
IV pain med [L]
give best relief and is indicated TV/Movie [*]
Epidural [S] The nurse should consider:
(what does the patient desire): Temperature [*]
Nitrous Oxide [I] 3DWLHQW¶VOLIH
Tub/bath/shower [S] Whispering
Hot pack/cold pack [*] voices [*] Sexual abuse
Water injections [S] Fear
Massage/pressure [*] Stress
Follow: Interpersonal dynamics
Movement/ambulation/
Unit position changes [S]
Service line Birth ball [*]
Hospital Focus points [*]
Breathing techniques [*]
Guidelines/standards Acupuncture [S] Offer social work consult
for pharmacologic Self-Hypnosis [S]
intervention TENS [*]

Reassessment

Coping Not Coping

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leissa.roberts@nurs.utah.edu