At 9:00 a.m., the OB nurse assesses fetal station at 0. The laboring woman has strong, regular contractions. At 10:30 a.m., the nurse again assesses fetal station at 0. What action by the nurse is best?
A.
Document the findings and continue to assess frequently.
B.
Encourage the woman to bear down during contractions.
C.
Increase the woman's IV fluid rate and reassess in 30 minutes.
D.
Inform the provider and prepare for possible cesarean delivery.
ANS: D
As labor advances and the presenting fetal part descends, the station should progress to a numerically higher positive station (numerically higher positive number). If the station does not change in the presence of strong, regular contractions, this may indicate a problem with the relationship between the maternal pelvis and the fetus (cephalopelvic disproportion). The nurse should inform the provider and prepare for a possible cesarean delivery. Documentation should occur in all situations, but more action is needed. Increasing the IV fluid rate is not warranted. The woman should be encouraged to bear down only after the cervix is totally dilated.
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