Assignment Task: Laboring Without an Epidural
Jamie is a 16-year-old G1 P0 who has been admitted with preeclampsia with severe features at 34 weeks of gestation. Jamie's physician plans to induce labor and anticipates a vaginal birth. Jamie has not attended any childbirth preparation classes and has been planning to have an epidural for labor and birth. Unfortunately, because her platelet count is very low (28,000), the anesthesia care provider refuses to place an epidural block. Jamie bursts into tears and says, "I can't make it through labor without an epidural! It's going to hurt too much! Help me!!"
1. Evidence-Is there sufficient evidence regarding avoiding neuraxial anesthesia in women who have low platelet counts?
2. Assumptions-Describe an underlying assumption about each of the following non pharmacologic or pharmacologic methods for pain relief during labor:
a. Breathing and relaxation techniques
b. Application of heat and cold
c. Systemic analgesia
d. Presence of a support person to increase effectiveness of interventions for pain
3. What implications and priorities for nursing care can be drawn at this time?
4. Does the evidence objectively support your argument (conclusion)?
5. Interprofessional care-Describe the roles/responsibilities of health care professionals who might be involved in Jamie's care.