A nurse is caring for a client who is receiving oxytocin via continuous IV infusion and is experiencing persistent late decelerations in the FHR. After discontinuing the infusion, which of the following actions should the nurse take?

Rationale:

A. Raw carrots: While carrots are nutritious, they are not significant sources of vitamin B12, which is typically lacking in a vegan diet.

B. Brown rice: Brown rice is a whole grain and a good source of certain B vitamins like niacin and thiamine, but it does not contain vitamin B12, which is important for those following a vegan diet.

C. Fresh citrus fruits: Citrus fruits are rich in vitamin C but do not provide significant amounts of vitamin B12.

D. Fortified soy milk:

Correct answer. Fortified soy milk is often enriched with vitamin B12, making it a suitable choice for individuals following a vegan diet who may struggle to obtain adequate amounts of this vitamin from plant-based sources.

A. Administering broad-spectrum antibiotics is important because a leaking myelomeningocele increases the newborn’s risk for infection, including meningitis. Early prophylactic antibiotic therapy helps prevent serious complications.

B. Cleansing the site with povidone-iodine is not recommended because antiseptics can irritate neural tissue and worsen leakage. The sac should be kept sterile and moist using a saline-soaked sterile dressing instead.

C. Monitoring rectal temperature is contraindicated because rectal manipulation can risk trauma to the myelomeningocele sac. Noninvasive temperature monitoring, such as axillary measurement, is safer.

D. Surgical closure should be performed as soon as possible, ideally within 24–48 hours after birth, rather than waiting 72 hours, to reduce the risk of infection and further neurologic damage.