A nurse is caring for a client who is in labor. Which of the following findings should prompt the nurse to reassess the client?

A. Previous cervical cerclage

Cervical cerclage is a surgical procedure in which a stitch is placed in the cervix to reinforce it and reduce the risk of preterm birth. The fact that the client has had a previous cervical cerclage suggests a history of cervical insufficiency or a shortened cervix, which increases the risk of preterm delivery in subsequent pregnancies.

B. Previous delivery at 37 weeks gestation: A delivery at 37 weeks gestation is considered term. While it is on the earlier side of term, it does not inherently indicate an increased risk for preterm delivery.

C. Previous delivery of a newborn weighing 2.5 kg (5.5 lb): While low birth weight can be associated with preterm birth, the weight alone does not necessarily indicate a history of preterm delivery. Birth weight can be influenced by various factors.

D. Previous reactive non-stress test: A reactive non-stress test is a reassuring result, indicating that the fetus is responsive and generally doing well. It does not suggest a history or risk of preterm delivery.

A. Intense contractions lasting 45 to 60 seconds: Intense contractions within a normal duration are typical during the active phase of labor. This finding does not necessarily warrant immediate reassessment but rather ongoing monitoring.

B. A sense of excitement and warm, flushed skin: A sense of excitement and warm, flushed skin may be associated with the transition phase of labor and is not necessarily a cause for immediate concern.

C. An urge to have a bowel movement during contractions: This is the correct answer. The urge to have a bowel movement may indicate fetal descent and the need to assess for full cervical dilation. It could signal the need for imminent delivery, and the nurse should promptly assess the client's cervix and notify the healthcare provider.

D. Progressive sacral discomfort during contractions: Discomfort, including sacral discomfort, is common during labor. Progressive sacral discomfort may be associated with the normal progression of labor and is not a reason for immediate reassessment.