The multiparous client at term has arrived to the labor and delivery unit in active labor with intact membranes. Leopold maneuvers indicate the fetus is in a transverse lie with a shoulder presentation. Which physician order is most important?
1. Artificially rupture membranes.
2. Apply internal fetal scalp electrode.
3. Monitor maternal blood pressure every 15 minutes.
4. Alert surgical team of urgent cesarean.
4
Explanation: 4. This is the highest priority because vaginal birth is impossible with a transverse lie. Labor should not be allowed to continue, and a cesarean birth is done quickly.
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