1. Stacy Troxel-11/11/09
2. #1-Latent Phase
   1. Pain Control
      1. -pain from cx dilating, & hypoxia to uterus
         1. -change position
            1. -hydrotherapy
            2. -massage
            3. -heat and cold packs
            4. -music, focal points, photos
            5. -aromatherapy
            6. -breathing patterns
            7. -doulas
   2. NRSG Interventions
      1. -est. rapport
         1. -teach breathing
            1. -assist with comfort/position
            2. -encourage mom to void q1-2hrs
            3. -orient to room, equipment, ect.
            4. -monitor progress
            5. -offer fluids/ice chips
            6. -watch vitals
   3. Physical Changes
      1. -0-3cm dilated
         1. -ctx q10-20min &15-20sec duration
            1. -ctx are irregular & mild
            2. -ctx soon become q5-7min & 30-40sec duration
            3. -ctx will be moderate intensity
   4. Emotional Changes
      1. -happy, talkative, eager
         1. -relief labor is started
            1. -nervous/excited
3. #2-Active Phase
   1. Pain Control
      1. -pain in peri area
         1. -cont. tech. in latent phase
            1. -short term pain meds
            2. -epidural
   2. Emotional Changes
      1. -helplessness
         1. -fatigue
            1. -anxious
            2. -nervous
            3. -fear
            4. -more dependent
   3. Physical Changes
      1. -4-7cm dilated
         1. -ctx q2-3 minutes
            1. -ctx 40-60sec duration
            2. -strong intensity ctx
   4. NRSG Interventions
      1. -encourage breathing
         1. -low stimuli
            1. -support her
            2. -give back rubs
            3. -provide comfort
            4. -help with position
            5. -encourage mom to void q1-2hrs
            6. -offer shower/whirlpool
            7. -watch vitals
4. #3-Transition Phase
   1. Pain Control
      1. -burning in vag
         1. -need to push
            1. -pushing should be a relief
   2. Emotional Changes
      1. -fatigue
         1. -restless
            1. -ready to quit
            2. -fear of tearing
   3. Physical Changes
      1. -8-10cm dilated
         1. -ctx q2 min
            1. -60-75sec duration
            2. -strong ctx!
   4. NRSG Interventions
      1. -encourage to rest between ctx
         1. -encourage breathing
            1. -support her
            2. -keep her informed
            3. -promote comfort
            4. -provide ice chips
            5. -watch vitals