In the picture below, each line represents 1 cm with regard to fetal station.
What station would describe the darkened line?

Choice A rationale

While monitoring for contractions is important, the most critical assessment is the fetal heart rate. Contractions can occur during and after the procedure, but their presence alone is not as indicative of fetal well-being or distress as a change in the fetal heart rate. The contractions themselves are expected and a direct result of the manipulation of the uterus.

Choice B rationale

Checking the amniotic fluid volume is typically done via ultrasound prior to the procedure to ensure there's enough fluid for the fetus to be mobile. A version is contraindicated if there is insufficient fluid (oligohydramnios). However, this is a pre-procedure assessment, and a real-time assessment during and after the procedure is focused on the fetal response.

Choice C rationale

During a version, the fetus is manually repositioned, which can cause transient umbilical cord compression or placental abruption. Monitoring the fetal heart rate is paramount to detect signs of fetal distress, such as bradycardia or persistent decelerations, which would necessitate immediate cessation of the procedure. This assessment is the most direct indicator of fetal tolerance.

Choice D rationale

Monitoring for vaginal bleeding is important post-procedure to detect a placental abruption, which is a potential complication. However, changes in the fetal heart rate are often the earliest and most direct sign of fetal compromise and should be monitored continuously, both during and immediately after the procedure. Vaginal bleeding may be a later sign.

Choice A rationale

The statement, "I am glad they are giving me something to try to stop my labor for now," shows a correct understanding of nifedipine's role as a tocolytic agent. Nifedipine, a calcium channel blocker, works by inhibiting the influx of calcium into uterine muscle cells, which is necessary for contraction. This effectively slows or stops preterm labor, giving time for corticosteroids to work.

Choice B rationale

The statement, "This medication can lower my blood pressure to dangerous levels," shows a correct understanding of a major side effect of nifedipine. As a calcium channel blocker, it causes vasodilation, which can lead to a drop in blood pressure. The patient should be monitored for hypotension and advised to report symptoms like dizziness or lightheadedness.

Choice C rationale

The statement, "I will let you know if I feel dizzy," indicates a correct understanding of a common symptom associated with the hypotensive effect of nifedipine. Dizziness is a direct result of decreased cerebral blood flow due to lower blood pressure. Reporting this symptom allows the nurse to intervene and prevent falls or other complications.

Choice D rationale

The statement, "Nifedipine should help mature my baby's lungs," is incorrect. Nifedipine is a tocolytic used to stop uterine contractions. The medication used to promote fetal lung maturity is a corticosteroid, such as betamethasone. This statement indicates a need for additional teaching to differentiate the purpose of these two classes of medications.