A laboring client received nalbuphine (Nubain) IV 90 minutes before she gave birth.
Which of the following medications should be available to reduce the postnatal effects of nalbuphine (Nubain) on the neonate?

The correct answer is C. The test results are normal.

Choice A rationale:

A biophysical profile (BPP) score of 8 does not necessarily indicate a need for immediate cesarean delivery.

Cesarean delivery is typically reserved for cases where there is a clear and urgent risk to the health of the mother or fetus, such as severe fetal distress or placental abruption.

A score of 8, while not the highest possible score, is still within the normal range and does not, by itself, constitute a reason for immediate surgical intervention.

Choice B rationale:

Additional tests may be considered in certain cases, such as when the BPP score is borderline or when there are other risk factors present.

However, a score of 8 is generally considered reassuring and does not typically warrant further testing.

It's essential to evaluate the BPP score in the context of the overall clinical picture, including the gestational age, maternal health, and fetal history.

Choice D rationale:

While an obstetric specialist may review the BPP results and discuss delivery options with the patient, this is not typically done within a week for a score of 8.

A score of 8 indicates reassuring fetal well-being, and there is usually no need for such urgent consultation or decision-making.

The timing of delivery discussions would depend on the overall clinical situation and the patient's individual preferences.

Choice C rationale:

A BPP score of 8 is considered normal.

It suggests that the fetus is well-oxygenated and has normal heart rate, breathing movements, muscle tone, and amniotic fluid levels.

This score does not raise immediate concerns about fetal well-being and does not typically require any immediate interventions.

Choice A rationale:

Bishop score: A tool used to assess the readiness of the cervix for labor induction. It evaluates factors such as cervical dilation, effacement, consistency, position, and station of the fetal presenting part.

Score ranges from 0 to 13: A higher score indicates a more favorable cervix for induction.

Score of 6 or less: Induction is less likely to be successful.

Score of 9 or higher: Induction is more likely to be successful.

Nurses understand: The importance of the Bishop score in predicting the likelihood of successful induction.

Nurses use this information: To counsel patients about the risks and benefits of induction, to prepare for induction, and to monitor progress during induction.

Choice B rationale:

Not always done for medical reasons: Induction can also be elective, meaning it is chosen for non-medical reasons, such as convenience or a desire to avoid a post-term pregnancy.

Examples of medical reasons:

Gestational hypertension or preeclampsia

Fetal growth restriction

Prolonged pregnancy

Chorioamnionitis

Oligohydramnios

Choice C rationale:

Trial of labor (TOL): A term used to describe a vaginal birth attempt after a previous cesarean delivery.

Not synonymous with induction of labor: TOL can occur spontaneously or be induced.

Choice D rationale:

Not always electively done at 37 weeks' gestation: The decision to induce labor at 37 weeks is made on a case-by-case basis.

Factors considered:

Maternal and fetal health

Bishop score

Patient preferences