A first-time 22-year-old single labor client, accompanied by her boyfriend, is admitted to the labor unit with ruptured membranes and mild to moderate contractions. She is determined to be 2 centimeters dilated
Which nursing diagnoses might apply during the current stage of labor? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Fear/Anxiety related to discomfort of labor and unknown labor outcome
2. Knowledge, Deficient, related to lack of information about pushing methods
3. Pain, Acute, related to uterine contractions, cervical dilatation, and fetal descent
4. Pain, Acute, related to perineal trauma
5. Coping: Family, Compromised, related to labor process
1, 3, 5
Explanation: 1. A Fear/Anxiety diagnosis would apply to the first stage of labor for a first-time labor client.
3. Contractions become more regular in frequency and duration, increasing discomfort and pain.
5. The woman and her boyfriend are about to undergo one of the most meaningful and stressful events in life together. Physical and psychologic resources, coping mechanisms, and support systems will all be challenged.
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