The nurse is assessing a patient in Labor with the findings in the chart: Fatal heart rate 135 with early decelerations. What action will the nurse implement?

Choice A reason: Lack of prenatal care is a significant risk factor for neural tube defects, including myelomeningocele, because it often means the mother did not receive important prenatal vitamins like folic acid, which are crucial for proper neural tube development. Prenatal care provides essential screenings and supplements to support a healthy pregnancy and fatal development. Without it, the risk of congenital anomalies, such as myelomeningocele, increases significantly. Additionally, prenatal care helps in identifying and managing other risk factors and conditions that may affect both maternal and fatal health.

Choice B reason: While active Labor with wounds requires medical attention and may pose risks to both mother and baby, it does not directly correlate with an increased risk of myelomeningocele. Myelomeningocele is a congenital condition related to neural tube development early in pregnancy. The presence of wounds in active Labor may indicate complications such as trauma or infection, but these are not associated with neural tube defects.

Choice C reason: Premature rupture of membranes (PROM) is a condition where the amniotic sac ruptures before Labor begins, potentially leading to preterm birth and infections. While PROM is a concern and requires appropriate medical intervention, it is not directly linked to the development of myelomeningocele. The causes of PROM and neural tube defects like myelomeningocele are different, with PROM often related to issues with the amniotic sac or maternal infections.

Choice D reason: Precipitous Labor, which is an unusually rapid Labor and delivery, can pose risks such as trauma to the birth canal and complications for the newborn, but it is not associated with an increased risk of myelomeningocele. The speed of Labor and delivery is not a contributing factor to neural tube defects. Instead, precipitous Labor is more concerning for potential delivery complications and the need for rapid medical response.

Choice A reason: Requesting an enteral tube is not necessary unless the child is unable to eat orally at all. The goal is to support the child's ability to eat independently, if possible.

Choice B reason: Providing large, padded utensils can help a child with cerebral palsy improve their ability to eat independently. Adaptive utensils are designed to accommodate the motor challenges that children with cerebral palsy may face, making it easier for them to grasp and use the utensils.

Choice C reason: While having the parents feed the child can be a short-term solution, it does not promote independence. The focus should be on finding ways to support the child's ability to eat on their own.

Choice D reason: Referring the patient to a nutritionist can be helpful for overall dietary management, but it does not directly address the immediate issue of the child's difficulty with using regular utensils. Adaptive utensils are a more direct solution to this problem.