Intrauterine resuscitation for an evolving category II or category III tracing includes (Select all that apply):

Choice A: Maternal pelvis is gynecoid is not a contributing factor of difficult, prolonged labor. On the contrary, a gynecoid pelvis is the most favorable shape for vaginal delivery, as it has a round inlet and a wide outlet that can accommodate the fetal heaD.

Choice B: Fetal position is persistent occiput posterior is a contributing factor of difficult, prolonged labor. In this position, the back of the fetal head is against the mother's sacrum, which can cause a poor fit in the pelvis and increase the resistance and the pressure on the maternal tissues. This can result in a longer and more painful labor, often associated with a severe backachE.

Choice C: Fetal attitude is in general flexion is not a contributing factor of difficult, prolonged labor. On the contrary, a general flexion attitude is the most optimal for vaginal delivery, as it allows the smallest diameter of the fetal head to pass through the birth canal.

Choice D: Fetal lie is longitudinal is not a contributing factor of difficult, prolonged labor. On the contrary, a longitudinal lie is the most common and favorable for vaginal delivery, as it means that the long axis of the fetus is parallel to the long axis of the mother.

Choice A: Increasing IV fluid rate is a secondary action, as it helps restore the blood volume and improve the blood pressure and the fetal perfusion. The nurse should perform this action after taking the first action.

Choice B: Elevating the legs is a tertiary action, as it helps increase the venous return and the cardiac output and improve the blood pressure and the fetal perfusion. The nurse should perform this action after taking the first and second actions.

Choice C: Notifying the provider is a quaternary action, as it helps communicate the situation and obtain further orders and interventions. The nurse should perform this action after taking the first, second, and third actions.

Choice D: Placing the client in a lateral position to relieve pressure on the inferior vena cava is the first and most important action, as it helps prevent or correct the hypotension and the fetal bradycardia caused by the epidural anesthesia block. The epidural anesthesia block can block the sympathetic nerve fibers and cause vasodilation and pooling of blood in the lower extremities, which can reduce the blood pressure and the placental perfusion. The pressure of the gravid uterus on the inferior vena cava can also reduce the venous return and the cardiac output, which can worsen the hypotension and the fetal bradycardiA. By placing the client in a lateral position, the nurse can reduce the pressure on the inferior vena cava and improve the blood flow and the oxygen delivery to the fetus.