L&D Nursing: How would you answer this pt's question?

[LoveLei]

The patient is 5 cm dilated, 100% effaced, -1 station and ROA. There is scant amount of bloody show. VS: T 37 (98.6), P98, R30, BP 116/70, 02 sat = 100%.

The physician artificially ruptures the membranes for a moderate amount of meconium stained fluid.

The patient asks the nurse, "Why is my bag of waters fluid green? Is the baby okay?"

What is the proper response by the nurse? I hear and see one thing in clinicals, but my text says another. I know that thick green meconium is cause for concern bc it can indicate fetal distress. But what about moderate amounts of mec? And how would you answer the pts question?

[Daytonite, BSN, RN]

It was done to help move the labor and birth along.

[kfarinato]

Amniotic sac is broken to speed labor along, not d/t mec(would not be known before ROM) Mec stained fluid can often just indicate a baby that is ready to get out- ie 40+weeks gestation.

Tell your patient that extra precautions will need to be taken when the baby is delivered. Depending on facility this may mean brief intubation w/ deep suctioning (no stimulation prior, to prevent aspiration of the mec) or good suctioning as the head is delivered.

[MissBrittanyRN]

I am a new grad, not in L&D, but worked in L&D as a tech for almost 3 yrs. The nurses would have answered her question, the actual question the patient asked. They would have told her exactly why it was green, and that although meconium could indicate fetal distress, they have no other reasons to be concerned that her baby is in distress at that point in time(FHR, etc). Then they would have said that if anything occurs that concerns the staff, the parents will be kept informed. They also probably would have told her that although it is not "normal" for meconium before delivery, it is not that uncommon either, and that there is protocol related to meconium delivery (in terms that she can understand). We would automatically have NICU and respiratory present, but that it is just a precaution, and do not let the additional staff in the room automatically concern her. She will remain updated at all times about the condition of her and her baby.