The perinatal nurse assesses a patient who is immersed in a water-filled tub during active labor. The assessments that indicate the hydrotherapy has been effective include which of the following? (Select all that apply.)
A.
Decreased fetal heart rate
B.
Increased maternal blood pressure
C.
Increased maternal temperature
D.
Increased uterine activity
E.
Patient's report of less pain
ANS: D, E
Hydrotherapy is effective when it provides relief from labor discomfort and pain by decreasing maternal catecholamines, prompting an increase in the release of oxytocin (stimulates uterine contractions) and endorphins (reduce the perception of pain). With decreased catecholamine release, blood pressure should remain stable or decrease. Of course the patient's report of lessened pain is the most valuable assessment. During immersion, the maternal temperature and fetal heart rate should remain stable.
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