A woman reports feeling uterine contractions that are strong, but on subsequent cervical checks, the nurse does not note any changes. What action by the nurse is most appropriate?
A.
Assess the woman for causes of anxiety.
B.
Attempt an external version of the fetus.
C.
Instruct the woman on nipple stimulation.
D.
Prepare to administer oxytoxin (Pitocin).
ANS: A
This woman is experiencing hypertonic labor (strong but ineffective contractions). Because maternal anxiety is a major causative factor, the nurse should first assess for anxiety and help to relieve it. A fetal occiput-posterior malposition is also a cause of hypertonic labor, and the nurse should assess for this condition using Leopold maneuvers; however, the health-care provider would perform any attempt at version. Nipple stimulation and oxytocin would be used in hypotonic labor.
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