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

Choice A: Explaining to the client what is happening over the next few minutes in detail and asking for teach back from the spouse is not the first action, as it may delay the urgent intervention and increase the anxiety of the client and the spousE. The nurse should provide brief and clear information and reassurance after taking the first action.

Choice B: Placing the client in a knee-chest or Trendelenburg position and raising the presenting part off the cord with your hand is the first and most important action, as it relieves the pressure on the cord and prevents cord compression and fetal hypoxiA. The nurse should maintain this position until the delivery.

Choice C: Covering the cord with a sterile, moist saline dressing is a secondary action, as it prevents the cord from drying and reduces the risk of infection. The nurse should perform this action after taking the first action.

Choice D: Preparing the client for an emergency cesarean birth is a tertiary action, as it is the definitive treatment for cord prolapse and ensures the safety of the mother and the fetus. The nurse should perform this action after taking the first and second actions.

Choice A reason: This is the correct action because a full bladder can cause the uterus to be displaced and prevent it from contracting properly, leading to uterine atony and excessive bleedinG. Asking the client to empty her bladder can help the fundus to return to the midline and reduce the lochiA.

Choice B reason: This is not the correct action because the client's temperature is within the normal range for the first 24 hours postpartum. A slight elevation in temperature can be due to dehydration, exertion, or milk production. The nurse should monitor the client's temperature and encourage fluid intake, but it is not a priority action.

Choice C reason: This is not the correct action because increasing IV fluids can cause fluid overload and worsen the bleedinG. The nurse should assess the client's fluid status and adjust the IV rate accordingly, but it is not a priority action.

Choice D reason: This is not the correct action because massaging the fundus can cause more bleeding and pain. The nurse should only massage the fundus if it is not firm and contracteD. Massaging a boggy fundus can help expel clots and reduce bleeding, but it is not indicated for a deviated fundus.