A nurse is caring for a client who presents to a labor and delivery unit experiencing rapidly progressing labor. Which of the following is the priority action for the nurse to take?

Choice A Reason:

Cholecystitis is correct. Both estrogen and progesterone have been shown to increase the risk of gallstones.Estrogen has been shown to increase cholesterol production in the liver, with excess amounts precipitating in bile and leading to the formation of gallstones.Progesterone has been shown to decrease gall-bladder motility, which impedes bile flow and leads to gallstone formation.

Choice B Reason:

Hypertension is correct. Women with uncontrolled hypertension or severe hypertension are generally advised against using oral contraceptives due to the increased risk of cardiovascular events.

Choice C Reason:

Human papillomavirus (HPV) is incorrect. HPV is not a contraindication to oral contraceptives.Overall, while there may be some association between oral contraceptive use and HPV infection or its progression, the absolute increase in risk is generally considered small, and the benefits of oral contraceptives in preventing unintended pregnancies and managing menstrual issues often outweigh the potential risks.

Choice D Reason:

Migraine headaches is correct. Women with migraines with aura, especially those over 35 years old, are often advised against using estrogen-containing contraceptives due to an increased risk of stroke.

Choice E Reason:

Anxiety disorder is incorrect. Anxiety disorder alone is not a contraindication to oral contraceptives. However, individual health considerations should be discussed with a healthcare provider.

The correct answer is C. Place the client in a lateral position.

A. Elevating the client's legs is not the priority in this situation. Placing the client in a lateral position is more appropriate to improve blood flow and prevent supine hypotension.

B. Notifying the provider is an important action but not the immediate priority. Addressing the client's position and blood pressure is crucial before contacting the provider.

C. Placing the client in a lateral position is the priority nursing action.

The low blood pressure may be due to aortocaval compression (supine hypotension) caused by the weight of the uterus on the vena cava. Turning the client onto her side alleviates this compression and helps improve blood flow.

D. Monitoring vital signs every 5 minutes is important, but the immediate action should be to address the client's position and blood pressure. Continuous monitoring and further interventions can follow.