Cindy Bell, a 20-year-old gravida 2, para 1 at 40 weeks’ gestation, presents to you in the birthing unit with contractions every 5 to 7 minutes. She is accompanied by her husband. Spontaneous rupture...

Cindy Bell, a 20-year-old gravida 2, para 1 at 40 weeks’ gestation, presents to you in the birthing unit with contractions every 5 to 7 minutes. She is accompanied by her husband. Spontaneous rupture of membranes occurred 2 hours prior to admission. Cindy tells you that the fluid was colorless and clear. You orient Cindy and her family to the birthing room and perform a physical assessment, documenting the following data: vital signs are normal. A vaginal exam demonstrates the cervix is 75% effaced, 4 cm dilated with a vertex at –1 station in the LOP position. You place Cindy on an external fetal monitor. The fetal heart rate baseline is 140–147 with accelerations to 156; no decelerations are noted. Contractions are 5–6 minutes apart, moderate intensity and lasting 40–50 seconds. Cindy states she would like to stay out of bed as long as possible because lying down seems to make the contractions more painful, especially in her back.

1. Discuss the benefits of ambulation in labor.

2. Cindy would like her daughter to be present for the baby’s birth. What would you discuss with her about the impact of having a young sibling present during labor and birth?

3. What fetal heart rate assessment will best ensure fetal well-being during the period Cindy is ambulating?

4. When a nonreassuring fetal heart pattern is detected, what remedial nursing intervention is carried out?

5. What are indications for continuous fetal monitoring in labor?