Final answer:
During labor, Janine's cervix is only 2 cm dilated and the amniotic sac is intact, so she is admitted to the birthing unit and an IV infusion of pitocin is started to help progress labor. The newborn's first breath alters the circulatory pattern by expelling amniotic fluid from the lungs, increasing oxygen levels, and redirecting blood flow to oxygenate the lungs and provide systemic circulation.
Step-by-step explanation:
38. Janine is 41 weeks pregnant with her first child when she arrives at the birthing unit reporting that she believes she has been in labor "for days" but that "it's just not going anywhere." During the clinical exam, she experiences a few mild contractions, each lasting about 15-20 seconds; however, her cervix is found to be only 2 cm dilated, and the amniotic sac is intact. Janine is admitted to the birthing unit and an IV infusion of pitocin is started.
Contractions during labor help the cervix dilate and the amniotic sac to break, leading to the birth of the baby. In Janine's case, despite experiencing mild contractions, her cervix is only 2 cm dilated and the amniotic sac is still intact, indicating that labor has not progressed enough. To help Janine progress in labor, an IV infusion of pitocin is started. Pitocin is a synthetic hormone that stimulates stronger contractions and helps the cervix dilate, increasing the chances of a successful vaginal delivery.
39. When a newborn takes its first breath, several changes occur in the circulatory pattern. Before birth, the fetal lungs are filled with amniotic fluid and oxygen comes from the placenta. However, at birth, the fluid is expelled from the lungs as the baby breathes and the lungs expand. This leads to an increase in oxygen levels and a decrease in carbon dioxide levels in the blood. As a result, the closure of certain fetal circulatory pathways, such as the ductus arteriosus and the foramen ovale, occurs, redirecting blood flow to oxygenate the lungs and providing systemic circulation.