The nurse is caring for a client who has a primary cesarean section as her fetus is in a breech presentation. After the baby is born, the nurse notes that the heels of the neonate are up by the face and ears. The nurse suspects this baby was in what position in utero?

A client has not received any medication during labor. The client is having frequent contractions about every 1 to 2 minutes, has become irritable with the coach, and no longer will allow the nurse to palpate the fundus during contractions. The cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating:

The nurse is assessing the external fetal monitor and notes the following: fetal heart rate of 175 beats/min, decrease in variability, and variable decelerations. Which action should the nurse take first?

At 37 weeks’ gestation, a client is diagnosed with a class 2 placental abruption. The client is having acute abdominal pain with painful tetanic contractions. What is the priority in the care of this client?

The nurse is caring for a client who is G5P4 and at 41 weeks gestation. She presents to the labor and delivery unit for an elective labor induction. She is excited to have her fifth baby. An ultrasound reveals the fetus is about 3500 grams (7 lbs., 11 oz.). The nurse completes a vaginal exam. The client is 3 cm, 50% effaced, and at 0 station. The nurse states the fetus is in the right right occiput anterior (ROA) position. She is having contractions every 2 to 3 minutes. The nurse palpates her contractions and they feel like the tip of her nose. The labor is taking longer than expected. The nurse suspects she has not yet delivered related to which of the five labor components?

An infant born at 35 weeks gestation is being prepared for discharge home. The family brings in their infant car seat. The nurse conducts a car seat challenge test. For which finding would the nurse delay the infant’s discharge based on the results of this test?

A nurse works in a labor and delivery unit and sees this fetal heart rate tracing. The fetal heart rate baseline is 95-100 beats per minute. What is the nurse’s interpretation of this tracing?

A nurse makes the following observations when assessing a full-term baby who nursed for fifteen minutes and is being assessed at forty-five minutes post-birth: 9 lb 2 oz (4,139 grams), 21 inches long, TPR: Temp is 96.6 F (35.9 C), heart rate is 158, respiratory rate is 56, extremities are jittery, acrocyanosis is present, and he is sleepy.  Which of the following nursing actions is of the highest importance? 

The nurse is caring for a client in the first hour postoperatively who had a cesarean section. During the first hour, the nurse will check the vital signs, pain, incision, uterine fundus, and lochia 

The nurse assesses a neonate born at 39 weeks gestation via Cesarean section. The neonate has nasal flaring, grunting, and intercostal retractions. The respiratory rate is 82 breaths per minute, and there are crackles in the lungs on auscultation. The nurse suspects the newborn is having difficulty clearing the fluid from the lungs. What is the nurse’s assessment of the neonate’s most likely condition?