A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow. (Move the steps, placing them in the order of performance. Use all the steps.)

A. Prepare equipment needed for newborn resuscitation.

A. Preparing equipment needed for newborn resuscitation is the correct action.

Meconium-stained amniotic fluid can increase the risk of meconium aspiration syndrome in the newborn. While the fetal heart rate is reassuring, being prepared for potential newborn resuscitation is prudent given the meconium staining.

B. Performing endotracheal suctioning as soon as the fetal head is delivered is not the current standard of care. The American Academy of Pediatrics (AAP) no longer recommends routine suctioning of meconium-stained infants unless they show signs of respiratory distress, poor muscle tone, or a depressed heart rate.

C. Preparing the client for an ultrasound examination is not the immediate priority. Meconium-stained amniotic fluid may be associated with fetal distress, but the focus should be on the current labor and delivery situation.

D. Preparing the client for an emergency cesarean birth is not the first action.

The presence of meconium staining alone does not necessarily indicate the need for an emergency cesarean birth, especially if the fetal heart rate is reassuring.

Choice A Reason:

Percutaneous umbilical blood sampling (PUBS) is not appropriate. This invasive procedure involves sampling blood from the umbilical cord and is not typically used in the context of a positive contraction stress test.

Choice B Reason:

Amnioinfusion is not appropriate. Amnioinfusion is a procedure in which sterile fluid is infused into the amniotic cavity to alleviate conditions such as oligohydramnios. It is not a primary diagnostic test for assessing fetal well-being.

Choice C Reason:

Biophysical profile (BPP) is appropriate. The biophysical profile is a diagnostic test that assesses the well-being of the fetus by evaluating various parameters, including fetal heart rate, fetal breathing movements, fetal movements, fetal tone, and the amniotic fluid volume. This test provides additional information to assess fetal well-being and can help guide decisions about the timing and mode of delivery.

Choice D Reason:

Chorionic villus sampling (CVS) is inappropriate. CVS is a prenatal test used for diagnosing certain genetic conditions but is not indicated in the context of a positive contraction stress test.