Because cervical effacement and dilation are not progressing in a patient in labor, the doctor orders I.V. administration of oxytocin (Pitocin). Why should the nurse monitor the patient's fluid intake and output closely during oxytocin administration?

A. Open up the IV: Increasing the infusion of non-medicated fluids may improve maternal hydration and placental perfusion. However, this action does not stop the excessive uterine stimulation causing the hypertonicity. The primary pharmacological trigger must be addressed first to ensure safety.

B. Start oxygen per face mask: Administering oxygen helps mitigate fetal hypoxia resulting from reduced placental blood flow during prolonged contractions. This is a supportive measure rather than a corrective one. The source of the uterine tachysystole must be eliminated to restore normal perfusion.

C. Stop the oxytocin infusion: Hypertonic contractions significantly reduce oxygen exchange in the intervillous space. Discontinuing the exogenous oxytocin immediately decreases uterine muscle tone and prevents potential uterine rupture or fetal asphyxia. This is the most critical intervention to stop the adverse effect.

D. Turn the client on her left side: Lateral positioning helps maximize blood flow to the uterus by relieving pressure on the vena cava. While beneficial for fetal resuscitation, it cannot counteract the mechanical pressure of a hypertonic uterus. It is performed after stopping the medication infusion.

A. Latent: The latent phase of the first stage of labor involves cervical dilation from 0 to 6 centimeters. Contractions are typically mild and less frequent than every 3 minutes. At 10 centimeters, the client has moved far beyond the initial phase of cervical preparation.

B. Active: The active phase is characterized by rapid cervical dilation, traditionally occurring between 6 and 8 centimeters. While contractions are frequent, the cervix is not yet fully dilated. The transition to the second stage occurs only after the cervix reaches the 10-centimeter mark.

C. Second: The second stage of labor begins when the cervix is completely dilated at 10 centimeters and ends with the birth of the infant. The frequent, long-lasting contractions described are typical of the expulsive efforts needed in this stage. The patient is now ready for active pushing.

D. Transition: Transition is the final part of the first stage, occurring between 8 and 10 centimeters of dilation. It is the most intense phase, often accompanied by a strong urge to push. Once 10 centimeters is achieved, the patient has officially concluded transition and entered the second stage.