A nurse is caring for a client who is 2 days postpartum. Which of the following findings should the nurse report to the provider?

The nurse should prepare to administer naloxone and oxygen by face mask 10 L/min.

Rationale:

• Naloxone is used to reverse opioid-induced respiratory depression, which is a potential risk during moderate sedation.
• Oxygen by face mask 10 L/min is necessary to maintain adequate oxygenation during and after sedation, as respiratory depression can occur.

• Acetaminophen is not used for immediate management of sedation-related complications.
• An additional dose of fentanyl or propofol would deepen sedation, not manage its complications.
• Propranolol is a beta-blocker that is not indicated in this situation.

Anticipated Interventions:

• Initiate an IV infusion of lactated Ringer's
• Place the client in a left lateral position
• Maintain continuous monitoring of the FHR

Contraindicated Intervention:

• Monitor blood pressure every hour

Rationale:

• Initiate an IV infusion of lactated Ringer’s: Hydration is important for labor progression and maternal hemodynamic stability, especially considering the client has a history of chronic hypertension and gestational diabetes.
• Place the client in a left lateral position: This improves uteroplacental perfusion, helping to optimize fetal oxygenation.
• Maintain continuous monitoring of the FHR: The presence of meconium-stained amniotic fluid and an elevated FHR (165/min) suggests potential fetal distress, warranting continuous fetal monitoring.
• Monitor blood pressure every hour (Contraindicated): The client has chronic hypertension and gestational diabetes, both of which increase the risk for complications like preeclampsia and fetal distress. More frequent BP monitoring (e.g., every 15-30 minutes) is necessary to detect any abnormalities early.