LABOR AND DELIVERY NURSING: A Guide to Evidence-Based …

1 LABOR ANDDELIVERY NURSING: A Guide toEvidence- based PracticeMICHELLE L. MURRAY,PhD, RNC-OBandGAYLE M. HUELSMANN,BSN, RNC-OB, C-EFMNew YorkAbout the AuthorsMichelle L. Murray, PhD, RNC-OB,is an international educa-Dr. Murray has been an active member and officer of theAssociation of Women s Health, Obstetric, and Neonatal Nurs-tor, author, and expert in obstetric nursing . She has taughtnursing students and nurses in the United States, Canada, anding as well as the American Nurses Association s New MexicoNurses Association. She is an award winner in education fromBahrain. Dr. Murray has spent the majority of her career as alabor and DELIVERY nurse and as an obstetric nursing (formerly the Nurses Association of the AmericanCollege of Obstetricians and Gynecologists), and from theShe was appointed by the provost at the University of NewMexico as a clinical associate honor society, Sigma Theta Murray s company, Learning Resources International,Inc.

2 Produces clinical and educational products and seminarsGayle M. Huelsmann, BSN, RNC-OB, C-EFM,is certified infor LABOR and DELIVERY nurses and midwives. Since 1986, moreinpatient obstetrics and holds a certificate of added qualifica-than 50,000 obstetric care providers, including nurses, physi-tion in electronic fetal monitoring from the National Certifica-cians, and midwives, have participated in Dr. Murray s classestion Corporation in Chicago, Illinois. She has been an antepar-and seminars. Her work has been published in journals suchtal nurse and a LABOR and DELIVERY staff nurse for 28 years. InasBirth: Issues in Perinatal care ;The American Journal of Maternaladdition, she is a maternal air transport nurse with fixed wingChild nursing (MCN); theJournal of Perinatology; theJournal ofand rotor wing aircraft.

3 She is also an education resourceNursing care Quality; and theJournal of Obstetric, Gynecologic,nurse at Presbyterian Hospital in Albuquerque, New Neonatal nursing (JOGNN). Dr. Murray was also a contribu-Ms. Huelsmann is the co-author ofEssentials of Fetal Monitoringtor to the Association of Women s Health, Obstetric, and Neo-(3rd ed.) and the monograph onUterine Hyperstimulation: Phys-natal nursing (AWHONN) publication, nursing Managementiologic and Pharmacologic Causes with Results from a Survey ofof the Second Stage of LABOR . Her best-selling books include1000 Nurseswith Dr. Michelle Murray. Ms. Huelsmann is anAntepartal and Intrapartal Fetal Monitoring(3rd ed.)

4 AndEssen-award winner of the PRIDE nurse award from Presbyteriantials of Fetal Monitoring(3rd ed.). Her books and products areHospital. She was nominated by her peers for her exemplaryavailable at to patient 2009 Springer Publishing Company, LLCAll rights part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by anymeans, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisheror authorization through payment of the appropriate fees to the Copyright Clearance Center, Inc., 222 RosewoodDrive, Danvers, MA 01923, 978-750-8400, fax on the web Publishing Company, West 42nd StreetNew York, NY Springer Publishing Company, LLC11 West 42nd StreetNew York, NY Editor: Allan GraubardIllustrations: Ellena C.

5 Tapia and Gary HamrickProduction Editor: Jean Hurkin-TorresCover design: Steven PisanoComposition: International Graphic Services0910111213/54321 Library of Congress Cataloging-in-Publication DataPrinted in the United States of America by Bang PrintingDISCLAIMERThis book is not intended to replace your hospital s policies,The content of this book was based on the best availableresearch at the time it was written. Some studies may appearprocedures, guidelines, or protocols. It is not intended to dic-tate a standard of care . We recommend that the reader alwaysdated and may have been the only study on the subject thatwas readily available at the time of this publication.

6 Everyconsult current research and specific institutional policies be-fore performing any clinical procedure. This book is intendedattempt was made to provide current information that use during the process of orientation of nurses in the laborand DELIVERY setting, and to bring experienced nurses up toNeither the author nor the publisher shall be liable forany special, consequential, or exemplary damages resulting,date with regard to current practice and research findings. Itcan also be used as a reference or as a study Guide by nursesin whole or in part, from the readers use of, or reliance on,the information contained in this book.

7 The publisher has nopreparing to take a certification examination in the field ofinpatient obstetrics or LABOR and for the persistence or accuracy of URLs for anyexternal or third-party Internet Web sites referred to in thisThis book does not include directions for equipment useor specific tests. These must be learned in the hospital setting,publication and does not guarantee that any content on suchWeb sites is, or will remain, accurate or with a mastery- based skills checklist. In addition, care should be individualized to the questions appear at the end of each chapter asa complement to the learning process. Each chapter containsthe information necessary to answer the the AuthorsiiAcknowledgmentsixPrefacexiChapt er 1 Communication, Advocacy, and the Chain of Command1 Chapter 2 Patient Assessment17 Chapter 3 Phases and Stages of Labor45 Chapter 4 Pain Management75 Chapter 5 Positions for LABOR and Birth99 Chapter 6 Passenger, Placenta, and Cord109 Chapter 7 Passageway137 Chapter 8 Presentation, Station, and Position153 Chapter 9 Powers of LABOR .

8 Stimulation and Hyperstimulation171 Chapter 10 Psyche, Spirituality, and the Cultural Dimensions of Care195 Glossary207 Appendix AAbbreviations217 Appendix BAbbreviations to Avoid in Documentation223 Appendix COrientation to LABOR and Delivery225 Appendix DSample Orientation Skills Checklist227 Appendix EOrientation Log Chart233 Index235 AcknowledgmentsWe were helped in writing this book by many dedicated andJulie Holden, RN, BSN, MANurse Managerskilled LABOR and DELIVERY nurses who reviewed the manu-script and made suggestions for improvement. They are listedBeverly HospitalBeverly, Massachusettsbelow in alphabetical order:Susan Mocsny Baker, RNCT heresa Hyland, RNCYale New Haven HospitalStaff NurseUniversity of Massachusetts Memorial Medical CenterNew Haven, ConnecticutWorcester, MassachusettsWanda Jeavons, RNC, MSN, PNNPP erinatal Outreach CoordinatorDarcie Beckwith, RNC, MSNC linical Practice SpecialistAndrews Women s HospitalBaylor All Saints Medical CenterThe Birthing InnInova Loudoun HospitalFort Worth, TexasLeesburg, VirginiaSuzanne Ketchem, MSN, RNC, CNSD irector of Women s and Children s ServicesLynne Brengman, RN, BSN, MBAE ducation DepartmentMedical Center of AuroraAurora, ColoradoPeaceHealth St.

9 Joseph HospitalBellingham, WashingtonReta M. King, BSN, RNCS taff Nurse, LABOR and DeliveryCindy Curtis, RNC, IBCLC, CCES taff Nurse and Director of the Lactation CenterUniversity of New Mexico Medical CenterAlbuquerque, New MexicoCulpeper Regional HospitalFamily Birth CenterNanci Koperski, RNC, LNCC, MBA, MHSAC ulpeper, VirginiaLegal Nurse ConsultantOmaha, NebraskaGarla DeWall, RNCS taff Nurse, Family Birthing CenterDebra Mills, RN, BSN, MSN, CNSP resbyterian HospitalClinical Nurse Specialist, Family Birth CenterAlbuquerque, New MexicoMethodist HospitalSacramento, CaliforniaBecky Dunham, RNCS taff Nurse, LABOR and DeliveryAngela Murphy.

10 RNCD ublin Methodist HospitalCharge Nurse, Family Birthing CenterDublin, OhioPresbyterian HospitalAlbuquerque, New MexicoDonna McAfee Frye, RN, MNClinical DirectorNancy Powell, RNC, MSN, CNMW omen s and Children s Clinical ServicesClinical EducatorNashville, TennesseeShore Memorial HospitalSomers Point, New JerseyAurora Gumamit, RN, MSN, CNSC harge Nurse, LABOR and DeliveryMichelle Rupard, MSN, RNC, FNP, LNCCC orona Regional Medical CenterAssistant Professor, College of NursingCorona, CaliforniaThe University of North Carolina at PembrokeLaurinburg, North CarolinaLABOR AND DELIVERY nursing Guide TO Evidence-Based PRACTICExWendy Sinanan, RNDiana Wigham, RNC, MSNS taff Nurse, LABOR and DeliveryStaff Nurse, LABOR and DeliveryMt.