A nurse is teaching breathing techniques to a primigravida client at 36 weeks gestation during a prenatal class. Which breathing technique should the nurse emphasize as most beneficial during the active phase of labor?
1Shallow chest breathing at a rate of 50-60 breaths per minute
2Deep abdominal breathing with breath holding for 10 seconds
3Rapid panting breathing throughout the entire contraction
4Slow-paced breathing at 6-9 breaths per minute with rhythmic pattern✓ 정답
해설
Slow-paced breathing at 6-9 breaths per minute is most beneficial during active labor as it promotes relaxation, oxygenation, and control. Other options like shallow chest breathing, breath holding, or rapid panting can lead to hyperventilation, reduced oxygenation, or ineffective pain management.
Clinical Judgment
This question evaluates appropriate pain management interventions for each stage of labor. The key is to connect the characteristics of the Active Phase of Labor (contractions are strong and longer) with the purpose of the breathing technique (relaxation, pain control, preventing hyperventilation). Slow-paced breathing is most suitable for the active phase. This is because it helps the mother maintain a sense of control, maintain adequate oxygenation (6-9 breaths per minute), and focus on the pain through rhythm. The other options are more suitable for the early latent phase or the pushing stage, or are physiologically harmful methods.
Memory Tip:
Labor Active phase = Slow & Steady breathing (LASS). Remember that the active phase requires slow and steady breathing.
KR vs US:
In Korea, structured breathing technique education like the Lamaze method is common, but the US NGN/CJMM focuses more on Stage-Specific Adaptation and Client-Centered Teaching. That is, rather than one-sidedly teaching "this breathing technique is good for this stage," the emphasis is on a coaching approach where you explain the rationale—"Active phase contractions are like this, and the reason this breathing technique helps then is..."—and help the client find a rhythm that works for them.
Clinical Practice GuideBreathing techniques during labor should be applied adaptively according to the stage.- Early/Latent Phase: Deep Abdominal Breathing. Slowly inhale through the nose and exhale through the mouth.- Active Phase: Slow-paced breathing. Rhythmic breathing at 6–9 breaths per minute. Breathe slowly as the contraction begins, and gradually slow the breathing rate again after the peak.- Transition Phase: Light Chest Breathing or a "He-hee-hoo" pattern. Use as needed to prevent the urge to push.- Pushing Phase: Directed breathing (coached breathing). Take a deep breath and push for 5–6 seconds, or exhale briefly with a "hoo" during open-glottis pushing.
Caution:In SATA questions, you may encounter types such as "Select all appropriate breathing techniques during labor." You must distinguish between questions asking about "the most beneficial technique during the active phase" (like this question) and those asking about "techniques that can be taught throughout labor." In the latter case, correct answers may include Deep breathing from the early phase in addition to Slow-paced breathing. Also, Rapid panting is generally not recommended due to the risk of hyperventilation and respiratory alkalosis.
Active Phase of Labor — Active phase of labor. This is the period when the cervix dilates from 4 to 7 cm, with contractions becoming stronger and more frequent (about every 2-3 minutes, lasting 45-60 seconds), and pain increases.
Slow-paced Breathing — Breathing technique used during labor. It involves rhythmic breathing at about 6-9 breaths per minute and is suitable for the active phase. It helps promote relaxation, distract from pain, and prevent hyperventilation.
Hyperventilation — Hyperventilation. A condition where excessively rapid and deep breathing causes an abnormally low level of carbon dioxide in the blood. It can lead to respiratory alkalosis, causing dizziness, nausea, tingling in the extremities, and convulsions, and may result in reduced placental blood flow.
Primigravida — A first-time mother. This refers to a woman experiencing her first pregnancy.
Gate Control Theory of Pain — Gate control theory of pain. This theory suggests that non-painful stimuli (e.g., rhythmic breathing, massage) can inhibit the transmission of pain signals through a gating mechanism in the dorsal horn of the spinal cord. It is used to explain the effectiveness of breathing techniques during labor.