A nurse is teaching a client and her partner about oxytocin use for labor induction. Which client statement indicates that further teaching is needed?

Choice A reason: Administering an IV fluid bolus may be helpful in preventing hypotension or maintaining hydration, but it is not the most critical action before oxytocin induction. Oxytocin can cause uterine tachysystole and fetal distress, so fluid bolus alone does not address the primary risk.

Choice B reason: Inserting a urinary catheter can help monitor urine output and bladder distension, but it is not essential before starting oxytocin. Catheterization is more relevant in surgical or anesthesia contexts rather than induction safety.

Choice C reason: Performing glucose monitoring is important in diabetic clients, but it is not universally required before oxytocin induction. Oxytocin does not directly alter glucose metabolism, so this is not the priority action.

Choice D reason: Continuous electronic fetal monitoring is the most important action because oxytocin increases uterine contractions, which can reduce placental perfusion and oxygen delivery to the fetus. A client with a prior cesarean is at higher risk for uterine rupture, so monitoring ensures early detection of fetal distress or abnormal contraction patterns.

Choice A reason: Intermittent fetal heart auscultation is appropriate when contractions are infrequent and the fetal heart rate is reassuring. It allows monitoring without continuous electronic fetal monitoring, especially in low-risk cases.

Choice B reason: Nipple stimulation is a natural method to promote uterine contractions by stimulating endogenous oxytocin release. However, in this case, contractions are already present, and nipple stimulation is not contraindicated.

Choice C reason: Administration of IV fluids is safe and often necessary to maintain hydration, support uteroplacental perfusion, and prevent maternal hypotension.

Choice D reason: Vaginal examinations every hour are contraindicated because the client has had ruptured membranes for 18 hours. Frequent vaginal exams increase the risk of ascending infection (chorioamnionitis). Vaginal exams should be minimized and performed only when clinically indicated.