A client in the first stage of active labor is using a shallow pattern of rapid breaths that is twice the normal adult breathing rate. The client complains of feeling light-headed, dizzy, and states that her fingers are tingling. What action should the nurse implement?

• A. Notify the healthcare provider.
• B. Help her breathe into a paper bag.
• C. Administer oxygen via nasal cannula.
• D. Tell the client to slow her breathing.

Answer: (B)

Hyperventilation during labor lowers carbon dioxide in the blood, causing respiratory alkalosis. The light-headedness, dizziness, and tingling in the fingers are classic signs from cerebral vasoconstriction and decreased ionized calcium. The quickest way to correct this is to increase the amount of CO2 the client rebreathes. Breathing into a paper bag (or cupped hands) reintroduces expired air, raises PaCO2, and reverses the symptoms by restoring the acid-base balance.

While instructing the patient to slow her breathing can help, it may not rapidly address the underlying CO2 deficit as effectively as rebreathing expired air. Administering oxygen is not indicated here because the problem isn’t lack of oxygen but excessive CO2 loss. Notifying the provider isn’t the immediate action when the patient’s symptoms are clearly due to hyperventilation and can be reversed with this technique.