The support person for your labor client has been applying gentle massage to the client's upper back frequently over the past hour. Now, the labor client states that "it just isn't helping anymore."
Both the support person and labor client are becoming frustrated with each other's inability to make things less stressful during the labor process. What would be the best nursing response at this time?
a. Have the client change position and tell the support person to take a break.
b. Discuss the effects of habituation and suggest alternate measures that could be used to relieve pain.
c. Advise the client that this may be the best time to ask for an epidural.
d. Tell the client and support person that she must be progressing further and you will do a vaginal exam to determine progress.
ANS: B
The process of habituation occurs as nerve fibers become less responsive to massage efforts, so alternative methods should be suggested to reduce frustration and improve outcomes. Although it might be advisable to suggest a break for the support person, that will leave the client alone when she is clearly frustrated. Change of position may be advisable. There is no indication that the client wants to have anesthesia as part of the labor-birth plan. Vaginal exams are done to determine progress but the situation as stated does not indicate that the client is progressing further so this might lead to further frustration if the findings do not indicate progress.
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