A woman 38 weeks gestation experiencing severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the client and documents the following findings: temperature of 37.1°C, pulse rate of 96 beats per minute, respiratory rate of 24 breaths per minute, BP of 170/112 mm Hg. 3+ DTRs, and no ankle clonus. The nurse calls the provider with an update. The nurse should anticipate an order for which medication first?

A. Fetal hypoxia is typically indicated by abnormal FHR patterns, such as late decelerations, decreased or absent variability, bradycardia, or prolonged decelerations. In this scenario, the FHR shows a normal baseline, moderate variability, and accelerations, all of which suggest adequate oxygenation and fetal well-being.

B. Tachycardia is defined as a baseline FHR greater than 160 beats per minute. Causes of fetal tachycardia can include maternal fever, infection, medications, or fetal hypoxia, but this fetus has a baseline of 135 bpm, which is within the normal range of 110–160 bpm, so tachycardia is not present.

C. Bradycardia is defined as a baseline FHR less than 110 beats per minute. Causes of bradycardia can include prolonged cord compression, maternal hypotension, or congenital heart conditions, but this fetus has a baseline of 135 bpm, ruling out bradycardia.

D. This fetus exhibits a reassuring FHR pattern characterized by a normal baseline indicating adequate cardiac function, moderate variability reflecting an intact autonomic nervous system and good oxygenation, presence of accelerations demonstrating a responsive, well-oxygenated fetus, and absence of decelerations, indicating there is no evidence of uteroplacental compromise or cord compression.

A. Vaginal examination findings are documented in the order of cervical dilation / cervical effacement / fetal station. In this case, 6/90%/−1 means the cervix is 6 cm dilated, 90% effaced, and the fetal presenting part is at −1 station. Fetal station describes the relationship of the presenting part to the ischial spines, which are designated as station 0. Negative numbers indicate the presenting part is above the ischial spines, and positive numbers indicate it is below. Therefore, a station of −1 means the presenting part is 1 cm above the ischial spines, making this interpretation correct.
B. The first number in the documentation represents cervical dilation. A dilation of 6 cm indicates active labor. A dilation of 1 cm would be documented as 1/—/—, not 6, so this interpretation is incorrect.
C. A presenting part that is 1 cm below the ischial spines would be documented as +1 station. Because the finding is −1 station, this option incorrectly interprets the fetal position.
D. The second number represents cervical effacement. An effacement of 90% means the cervix is almost completely thinned and ready for delivery. An effacement of 70% does not match the documented finding and is therefore inaccurate.