A nurse is caring for a client who is in labor. Which of the following findings should prompt the nurse to reassess the client?

Plan care to minimize handling of the newborn. Neonatal abstinence syndrome (NAS) occurs in newborns who were exposed to addictive substances while in utero, and these newborns can experience symptoms of withdrawal. Minimizing handling can help to decrease stimulation, which can aggravate withdrawal symptoms in the newborn. Scheduling smaller, more frequent feedings is recommended because these newborns may have a poor appetite and a weak suck reflex. Swaddling with the newborn's legs flexed, also known as the "fetal position," can help to decrease stimulation and promote comfort. Maintaining eye contact can provide comfort and promote bonding, but it is not a priority intervention for managing NAS.

Uterine rupture. When a client has had two prior cesarean births, she is at an increased risk for uterine rupture. Uterine rupture is a serious complication that can occur during labor, where there is a tear in the wall of the uterus. It can lead to significant blood loss for the mother and oxygen deprivation for the fetus. Other risk factors for uterine rupture include a previous uterine surgery, the use of labor-inducing drugs, and multiple gestations.

Failure to progress (choice A) refers to a labor that is not progressing as it should, and can be caused by a variety of factors, including fetal malposition or inadequate contractions. Abruptio placentae (choice B) refers to the separation of the placenta from the uterine wall before delivery, which can cause fetal distress and maternal hemorrhage. Precipitous labor (choice C) refers to a labor that progresses extremely quickly, with contractions lasting less than 3 hours from the onset of active labor. While precipitous labor can be associated with increased risk for perineal lacerations and postpartum hemorrhage, it is not typically associated with prior cesarean births.