Alejandra, a 34-year-old pregnant female at 39 weeks’ gestation, arrives at the emergency department of her local hospital accompanied by her husband. She is experiencing regular contractions and reports escalating pain intensity. Alejandra is a gravida 2, para 1, with a history of a previous cesarean section. Alejandra describes her pain as intense and continuous, radiating from her lower abdomen to her lower back. She reports a desire for pain relief to cope with the discomfort of labor contractions. The couple expresses concerns about the potential for a prolonged and painful labor process. Alejandra's first pregnancy resulted in a cesarean section due to breech presentation. She has had a generally uncomplicated prenatal course during this pregnancy, with no significant medical issues. Regular prenatal checkups have shown a healthy fetus with no identified complications. Her vital signs are as follows: blood pressure: 122/78 mm Hg, heart rate: 96 bpm, respiratory rate: 20 breaths per minute, temperature: 98.6° F (37° C), and fetal heart rate: 140 bpm, regular rhythm.
1 .
What nonpharmacologic and pharmacologic pain management solutions can be offered to Alejandra, considering her history and current pain level, and how might involving her husband in the decision-making process enhance the effectiveness of these solutions?
2 .
After implementing pain management strategies, what indicators should the nurse monitor to assess the effectiveness of the interventions, and how might the nurse adjust the plan based on Alejandra's feedback and progress in labor?