The nurse is observing a fetal heart tracing of a term pregnant client in spontaneous labor and observes excessive uterine activity.
There are six contractions in 10 minutes over a 30-minute window and the fetal heart rate has changed to a category II tracing with late decelerations.
The client has been repositioned, oxygen has been initiated, and an IV fluid bolus is infusing.
The nurse anticipates an order for which medication?

Choice A rationale

Laminaria acts by absorbing fluid from surrounding tissue and expanding. It is made from dried seaweed and is used for cervical ripening. The expansion of Laminaria dilates the cervix mechanically, which can be useful for procedures like abortion or labor induction. The absorbent properties help create a natural dilation process.

Choice B rationale

Laminaria is not used for an amniotomy. Amniotomy involves rupturing the amniotic sac, usually done with a specialized tool like an amnihook. Laminaria, on the other hand, is used for its mechanical dilating properties, not for breaking the amniotic sac.

Choice C rationale

Laminaria is not a prostaglandin. Prostaglandins are hormone-like substances used to soften and thin the cervix, usually administered as a gel or insert. Laminaria works differently by physically expanding rather than chemically altering the cervix.

Choice D rationale

Laminaria is not a tablet that is swallowed. It is inserted into the cervical canal to promote dilation. Its mode of action is mechanical expansion, which is different from oral medications designed to induce labor or ripen the cervix.

Choice A rationale

Encouraging the patient to push harder during shoulder dystocia can worsen the situation by further impacting the shoulder against the pelvic bone.

Choice B rationale

Preparing for a cesarean birth is not the immediate priority action in the case of shoulder dystocia. Initial maneuvers should be attempted first.

Choice C rationale

Performing the McRoberts maneuver is the priority action. It involves hyperflexing the mother's legs tightly to her abdomen, which can help free the impacted shoulder.

Choice D rationale

Applying firm fundal pressure can worsen shoulder dystocia and should be avoided. Instead, suprapubic pressure can be applied to help dislodge the shoulder. .