• Tachycardia
• Pyrexia
• A dry mouth 
• Oliguria
• Ketonuria
• Increase or decrease in pulse, respiration, and blood pressure

ON THE MOTHER: Inadequate progress of labour due to poor uterine action in the first stage, and

poor maternal effort in bearing down during the second stage of labour. 

2. ON THE FETUS: Fetal distress due to hypoxia. This often results from incorrectly managed

cephalopelvic disproportion.

Interventions

Conserving Maternal Energy

• Reduce factors that interfere with patien'ts ability to relax
• Lower the light level and turn off overhead lights
• Reduce noise 
• Maintain comfortable maternal temperature
• Position the patient to encourage comfort, promote fetal descent, and enhance fetal oxygenation
• Use pillows for support- To reduce muscle strain and added fatigue
• Help change positions regularly-To reduce muscle tension from constant pressure and to promote maternal comfort by maintaining an even distribution of regional analgesia
• Soothing back rub-Reduces muscle tension
• Firm sacral pressure-Reduces back pain
• Using the birth ball-Used for relax and support in some positions
• Warmth on back-May reduce back pain
• Maintain intravenous fluids-Provides fluids and electrolytes
• Assess intake and output-To identify dehydration
• Provide clear liquids-Moisten the mouth and replenish energy

Interventions

Promoting Coping Skills

• Explain purpose and expected benefits of medical therapy and position changes
• Encourage visualization of the baby passing downward smoothly through the pelvis as a result of her efforts-Provides mental images that allow her to see effects of efforts
• Give generous praise and encouragement of the use of skills-Positive reinforcement
• Tell patient when she is making progress-knowing that her efforts are having the desired results and that the fetus is doing well gives the patient courage to continue

Patient will rest between contractions with her muscles relaxed. 

Patient will use coping skills, such as breathing and relaxation techniques

There is no specific test to diagnose maternal exhaustion. It is diagnosed with the used of observation of objectives and subjectives signs and symptoms. 

• Urinalysis for the presence of keytones
• Verbal expression of tiredness, fatigue, or exhaustion
• Verbal expression of frustration with a prolonged, unproductive labor
• Changes in pulse, respiration, and blood pressure

Used for analgesic effects

Meperidine

Fentanyl

Butorphanol

Nalbuphine

Promethazine

Diphenlydramine

Hydroxyzine

Naloxone

Naltrexone

Focus on relaxation and breathing techniques

Teach techniques to reduce stress and increase comfort

Teach about positions and position changes

Teach patient about coping skills