A nurse is caring for a client who is 42 weeks of gestation.

Exhibits

Based on the assessment findings, which of the following actions should the nurse plan to take? Click to specify whether the nurse's planned actions are anticipated, nonessential, or contraindicated

The correct answer is D.

A. Slowing the client's rate of breathing is not directly related to the observed uniform decelerations. The primary concern is the fetal heart rate pattern.

B. Decreasing the rate of infusion of the maintenance IV solution is not the appropriate intervention for addressing the observed fetal heart rate decelerations. The focus should be on the oxytocin infusion rate.

C. Increasing the rate of infusion of the IV oxytocin is not the appropriate action.

The patient is already experiencing frequent and strong contractions, and increasing the oxytocin rate can exacerbate the decelerations and compromise fetal well-being.

D. Discontinuing the infusion of the IV oxytocin is the correct action.

The observed uniform decelerations are likely related to oxytocin-induced hyperstimulation of the uterus. Stopping or decreasing the oxytocin infusion allows for the uterine activity to decrease, potentially improving fetal heart rate patterns.

The correct answer is D. "There are so many variables that you'll have to ask your obstetrician."

A. "It's too soon for you to be worrying about this now" dismisses the client's concerns and does not provide useful information. It's important to address the client's question and offer guidance.

B. "A repeat cesarean birth is safer for both you and your baby" may not be accurate for all situations. The decision on the mode of delivery (vaginal birth after cesarean - VBAC or repeat cesarean) depends on various factors, and a blanket statement may not apply.

C. "The primary consideration is what type of incision was performed this time" is partially correct.

The type of uterine incision in the current cesarean birth is one factor to consider, but it is not the only consideration. Other factors, such as the reason for the previous cesarean, maternal health, and the obstetrician's assessment, also play a role.

D. "There are so many variables that you'll have to ask your obstetrician" is the most appropriate response.

The decision regarding the mode of delivery in subsequent pregnancies after a cesarean is individualized and depends on various factors. The obstetrician will consider the woman's health, the reason for the previous cesarean, the type of uterine incision, and other relevant factors to provide personalized guidance.