A nurse is assisting with the care of a client who is in labor.
Which of the following findings should the nurse report to the provider?

Choice A rationale:

Evaluating the side effects of analgesia is not the priority action in this situation. While it's important to assess for potential

side effects, the client's immediate need to use the bathroom takes precedence.

Analgesia might contribute to urinary retention in some cases, but it's not the most likely reason for the client's request.

Promptly addressing the client's need to void helps prevent bladder distention, discomfort, and potential urinary tract

infections.

Choice B rationale:

Using a wheelchair is not necessary in most cases after a vaginal birth.

Early ambulation is generally encouraged to promote circulation, prevent blood clots, and aid in recovery.

Requiring a wheelchair could delay the client's ability to void and might make her feel less independent.

Choice C rationale:

Advising the client to remain in bed is not recommended practice after a vaginal birth.

Prolonged bed rest can increase the risk of complications, such as blood clots, muscle weakness, and delayed bowel function.

Early ambulation, as tolerated, is crucial for promoting physical recovery and preventing postpartum complications.

Choice A rationale:

Umbilical cord compression is the most common cause of variable decelerations. It occurs when the umbilical cord is

compressed, momentarily reducing blood flow to the fetus and causing a decrease in fetal heart rate.

Variable decelerations are characterized by their abrupt onset, variable duration, and unpredictable shape. They typically

recover quickly to the baseline fetal heart rate after the compression is relieved.

Several factors can contribute to umbilical cord compression, including:

Fetal movement: The fetus can sometimes move in a way that compresses the cord, especially during active labor.

Oligohydramnios (low amniotic fluid): With less amniotic fluid, there's less cushioning around the cord, making it more prone

to compression.

Nuchal cord (cord around the neck): If the cord is wrapped around the fetus's neck, it can become compressed during

contractions.

Short umbilical cord: A shorter cord has less slack, increasing the risk of compression.

Choice B rationale:

Maternal hypotension can cause fetal heart rate decelerations, but these typically present as late decelerations, not variable

decelerations. Late decelerations have a gradual onset, a uniform shape, and typically occur after the peak of a contraction.

Maternal hypotension can decrease placental blood flow, leading to fetal hypoxia (decreased oxygen supply). This hypoxia can

then trigger a decrease in fetal heart rate.

Choice C rationale:

The fetal sleep cycle does not typically cause variable decelerations in the fetal heart rate. During sleep, the fetal heart rate

may exhibit a decrease in baseline variability, but this is not the same as variable decelerations.

Choice D rationale:

The use of epidural anesthesia can sometimes cause a decrease in fetal heart rate variability, but it does not typically cause

variable decelerations. Epidural anesthesia can lead to maternal hypotension, which, as mentioned earlier, can cause late

decelerations.