During a breast examination on a 24-year-old client, the nurse notes the following findings. Which finding is of most concern and should be reported to the provider?

Choice A rationale:

The priority nursing action when the fetal heart rate shows a deceleration after the contraction has started, with the lowest point occurring after the peak of the contraction, is to change the client's position. This deceleration pattern is called "late decelerations,” and it is typically associated with uteroplacental insufficiency, which can be caused by maternal hypotension or impaired blood flow to the placenta. Changing the client's position, such as moving the client to their side or repositioning them, can alleviate pressure on the vena cava and improve blood flow to the placenta, thus potentially resolving or minimizing the late decelerations.

Choice B rationale:

Inserting a scalp electrode (Choice B) is not the priority action in this situation. While a scalp electrode may be used to monitor the fetal heart rate more accurately and continuously, it is not the initial intervention for addressing late decelerations.

Choice C rationale:

Preparing for amnioinfusion (Choice C) may be considered if there are variable decelerations (caused by cord compression) present, but it is not the priority intervention for late decelerations.

Choice D rationale:

Documenting benign decelerations (Choice D) is not appropriate in this scenario since late decelerations are not considered benign and require immediate action.

Choice A rationale:

Postpartum depression is a more severe and prolonged form of emotional response to childbirth. It involves persistent feelings of sadness, hopelessness, and difficulty bonding with the baby. The symptoms of postpartum depression are different from what the client is experiencing, so this choice is not correct.

Choice B rationale:

The taking-in phase is a normal emotional response to birth, where the mother is focused on her own needs and experiences during the immediate postpartum period. The client's symptoms do not align with this phase, as she is expressing feelings of sadness and crying for no reason.

Choice C rationale:

The postpartum blues, also known as the "baby blues,” is the correct choice. It is a common and transient emotional response to birth experienced by many new mothers. The mother may feel overwhelmed, have mood swings, and cry for no apparent reason. These symptoms usually resolve on their own within a few days to a couple of weeks, and supportive care is typically sufficient.

Choice D rationale:

The taking-hold phase is a phase where the mother becomes more confident in her caregiving abilities and starts to take a more active role in caring for her baby. The client's symptoms do not align with this phase, as she is expressing feelings of sadness and crying for no reason.