The nurse is caring for a laboring woman, G3 P2, who was examined 15 minutes ago.

Her cervix was 8 cm dilated and 90% effaced.

She now states she is feeling strong pressure in her rectum and wants to move her bowels.

Which of the following action should the nurse perform first?

Choice A rationale
The occiput anterior position is optimal for labor and birth due to the fetal head's alignment with the maternal pelvis, reducing resistance and facilitating descent through the birth canal.
Choice B rationale
The occiput posterior position can lead to prolonged labor and increased discomfort because the fetal head does not align with the maternal pelvis as effectively as in the anterior position.
Choice C rationale
The mentum posterior position is uncommon and often requires medical intervention, as the chin-first presentation can obstruct labor progression and prevent the fetus from passing through the birth canal.
Choice D rationale
The occiput transverse position may result in a difficult labor due to the fetal head being oriented sideways, hindering descent and potentially necessitating medical assistance or operative delivery.

Choice A rationale
Limited perception of bladder fullness can occur with epidural anesthesia, but it is not the most common or harmful complication. Patients should be monitored for urinary retention.
Choice B rationale
Severe afterbirth headache, or post-dural puncture headache, can result from epidural complications, but it is less common than hypotension.
Choice C rationale
Hypotension is the most common and potentially harmful complication of epidural anesthesia. It occurs due to sympathetic nerve blockade, leading to vasodilation and decreased cardiac output. Normal blood pressure ranges: systolic 90-120 mmHg, diastolic 60-80 mmHg.
Choice D rationale
Increased respiratory rate is not a common complication of epidural anesthesia. It is more likely related to anxiety or other factors and should be monitored accordingly.