A client in latent phase of labor for the past 12 hours is requesting medication to help her rest.

The correct answer is: d. Persistent fetal bradycardia below 100 bpm.

Choice A: Maternal pulse rate of 100 bpm

A maternal pulse rate of 100 beats per minute (bpm) is slightly elevated but not uncommon during labor due to the physical exertion and stress involved. The normal range for an adult’s resting heart rate is typically between 60 and 100 bpm. While it is important to monitor the maternal pulse, it is not an immediate cause for concern unless accompanied by other symptoms such as hypotension, chest pain, or signs of distress.

Choice B: Maternal blood pressure of 120/70 mm Hg

A maternal blood pressure of 120/70 mm Hg is within the normal range. Normal blood pressure for adults is generally considered to be around 120/80 mm Hg. This reading indicates that the mother is maintaining stable blood pressure during labor, which is a positive sign. Therefore, this does not require immediate reporting to the physician.

Choice C: Decrease in intensity of uterine contractions

A decrease in the intensity of uterine contractions can be concerning as it may indicate ineffective labor, which could prolong the delivery process. However, this is typically managed by adjusting oxytocin levels or other interventions and does not require immediate reporting unless it leads to other complications such as fetal distress.

Choice D: Persistent fetal bradycardia below 100 bpm

Persistent fetal bradycardia below 100 bpm is a significant concern and should be immediately reported to the physician. Normal fetal heart rate ranges from 110 to 160 bpm. Bradycardia, defined as a heart rate below 110 bpm, can indicate fetal distress, hypoxia, or other complications that may require urgent intervention to ensure the safety of the fetus. Persistent bradycardia, especially below 100 bpm, necessitates immediate medical attention to assess and address the underlying cause.

Choice A: the interval between contractions

Encouraging a laboring woman to push during the interval between contractions is not appropriate. During this time, the uterus is not contracting, and pushing would be ineffective and exhausting for the woman. The intervals are meant for rest and recovery to prepare for the next contraction.

Choice B: whenever she feels the need

While it is important to listen to the laboring woman’s instincts, pushing should be coordinated with contractions for maximum effectiveness. Pushing whenever she feels the need might not align with the contractions, leading to ineffective efforts and increased fatigue.

Choice C: second-stage of labor

The second stage of labor is the most appropriate time for the nurse to encourage a laboring woman to push. This stage begins when the cervix is fully dilated to 10 centimeters and ends with the birth of the baby. During this stage, contractions are strong and frequent, providing the necessary force to help push the baby through the birth canal.

Choice D: first-stage of labor

The first stage of labor involves the dilation and effacement of the cervix and is not the appropriate time for pushing. Pushing during this stage can cause unnecessary strain and may lead to complications. The focus during the first stage should be on managing contractions and conserving energy for the second stage.