The nurse is caring for a woman in labor. What signs or symptoms would indicate that the patient is in the transition stage of labor? 

Explanation

• During the transition phase of the first stage of labor, the maximum cervical dilation of 8 to 10 cm occurs, and contractions reach their peak of intensity and occur every 2 to 3 minutes at a duration of 60 to 90 seconds.

• During the transition phase, the woman may experience intense discomfort so strong it is accompanied by nausea and vomiting. Because of the intensity and duration of the contractions, she may experience a feeling of loss of control, anxiety, panic, and irritability. Since dilatation continues at a rapid rate, the membranes rupture and heavy show is present.

• Uncontrollable urge to push or bear down and bulging at the perineum are signs of the second stage of labor.

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