Patient Data Exhibits Review H and P, nurse's notes, laboratory results, flow sheet, and prescriptions. Click to highlight the findings that would indicate the client is progressing and ready for an epidural. 0245 Peripheral IV (PIV) started in left hand with 20 gauge catheter. Lab specimens drawn. IV fluids of lactated Ringer's started Infusing at 75 mL/hour. Contractions are now every 4 minutes lasting 45 seconds. Mother says they are getting more painful. Instructed her and husband on slow breathing and relaxation techniques. Husband will assist wife breathing. Client instructed she can have IV pain medication if she needs it until time for epidural. 0330 Contractions are now every 3 to 4 minutes apart and client reports they are really hurting. Asking for epidural. Healthcare provider (HCP) to bedside. SVE reveals 5 cm dilated, 90% effaced and 0 station. Performed artificial rupture of membranes with clear amniotic fluid.
Explanation & Rationale
Contractions every 3 to 4 minutes, lasting 45 seconds: This frequency and duration of contractions suggest the client is in active labor, and the pain is becoming more intense, indicating readiness for pain management through epidural anesthesia. Client's request for pain relief: The client’s request for an epidural due to increased pain is also a practical consideration for proceeding with epidural anesthesia. Her request aligns with the physical signs of progressing labor. 5 cm dilated, 90% effaced, 0 station: The client is in active labor with significant cervical change, meeting the typical criteria for an epidural, which is usually considered when the cervix is dilated to 4-5 cm. Artificial rupture of membranes with clear amniotic fluid: This procedure typically accelerates labor and further confirms the client is in the active stage of labor, reinforcing the need for pain management at this point.