A nurse is caring for a client who is 42 weeks of gestation. Based on the assessment findings, which of the following actions should the nurse plan to take? (Select all that apply.)

A. "Increase your intake of ironrich foods and take a prenatal vitamin."
Important, but not directly related to reducing the risk of neural tube defects. Ironrich foods and prenatal vitamins are essential for overall maternal and fetal health, but they do not specifically target neural tube defect prevention.
B. "Avoid any alcohol consumption."
Important advice during pregnancy to prevent fetal alcohol spectrum disorders, but not directly related to reducing the risk of neural tube defects.
C. "Take a folic acid supplement for at least 3 months before you get pregnant."
Correct: Adequate folic acid intake before conception and during early pregnancy can significantly reduce the risk of neural tube defects in newborns.
D. "Avoid all foods containing aspartame."Aspartame is an artificial sweetener that has been studied for safety in pregnancy, and there is currently no strong evidence linking it to neural tube defects. However, it's still a good idea
to limit the intake of artificial sweeteners during pregnancy and focus on a balanced diet.

The correct answer is B, C, and D.

Choice A: Increase the oxytocin infusion to 13 mu/min

Increasing the oxytocin infusion is not indicated in this scenario. Oxytocin is used to induce or augment labor, but if the fetal heart rate tracing is abnormal (Category 3), increasing oxytocin could exacerbate fetal distress. The priority is to stabilize the fetal condition before considering increasing oxytocin.

Choice B: Initiate a bolus of primary IV fluids

Initiating a bolus of primary IV fluids is appropriate. This action helps improve placental perfusion and maternal hydration, which can be beneficial in response to abnormal fetal heart rate tracings. Adequate hydration can enhance uteroplacental blood flow and improve fetal oxygenation.

Choice C: Place the client in a sidelying position

Placing the client in a sidelying position is recommended. This position can improve uteroplacental perfusion and fetal oxygenation, especially if there are signs of fetal distress. It helps to alleviate pressure on the inferior vena cava, enhancing blood flow to the placenta.

Choice D: Apply oxygen at 10 L/min via a venturi mask

While oxygen may be indicated for fetal distress, the correct method is usually a non-rebreather mask at 10 L/min, not a venturi mask. A venturi mask delivers more precise oxygen concentrations but not high-flow oxygen, which is needed in this scenario.

Choice E: Perform a sterile vaginal examination (SVE)

A vaginal exam assesses labor progression, cervical dilation, station, and fetal position. This is important for determining whether labor is progressing appropriately or whether further interventions are needed.