A woman is in labor. The fetus is in vertex position. When the patient's membranes rupture, the nurse sees that the amniotic fluid is meconium-stained. The nurse should immediately:
1. Change the patient's position in bed.
2. Notify the physician that birth is imminent.
3. Administer oxygen at 2 liters per minute.
4. Begin continuous fetal heart rate monitoring.
4
Rationale 1: Changing the patient's position is not indicated.
Rationale 2: Meconium-stained amniotic fluid does not indicate that birth is imminent.
Rationale 3: Oxygen administration is not indicated.
Rationale 4: Meconium-stained amniotic fluid is an abnormal fetal finding, and is an indication for continuous fetal monitoring.
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