A nurse is performing a contraction stress test (CST) on a client who is at 40 weeks of gestation.The results of the test indicate a negative CST.
Which of the following actions should the nurse take?

Choice A rationale

Methadone is often prescribed to pregnant women with opioid use disorder and is considered safe for breastfeeding. Breastfeeding can provide additional benefits such as bonding and transferring antibodies to the infant.

Choice B rationale

Methamphetamine use during pregnancy is linked to fetal growth restriction, preterm birth, and low birth weight, not fetal macrosomia (large body size).

Choice C rationale

Reducing environmental stimuli is essential for neonates exposed to substances in utero. Increased stimuli can overwhelm their underdeveloped nervous systems, leading to stress and adverse outcomes.

Choice D rationale

Fetal alcohol syndrome is characterized by growth deficiencies, facial abnormalities, and central nervous system dysfunction. An increased head circumference is not a typical feature; rather, microcephaly (small head circumference) is more common.

The nurse should prioritize monitoring the client's fundal tone followed by the client's blood pressure. Here's why:

1. Fundal Tone: The client's fundus is boggy and not firming up with massage. This is a priority concern as it indicates uterine atony, which is a major cause of postpartum hemorrhage.
2. Blood Pressure: Monitoring blood pressure is crucial as the client is experiencing heavy lochia, and a decrease in blood pressure can indicate hypovolemic shock due to blood loss.

So, the completed sentence would be:

• The nurse should first monitor the client's fundal tone followed by the client's blood pressure.

Taking care of immediate risks and stabilizing the patient is key in such cases.