The nurse is caring for a laboring woman, G3 P2, who was examined 15 minutes ago.

Her cervix was 8 cm dilated and 90% effaced.

She now states she is feeling strong pressure in her rectum and wants to move her bowels.

Which of the following action should the nurse perform first?

Choice A rationale
Umbilical cord compression typically causes variable decelerations in fetal heart rate, not accelerations. Accelerations are not related to cord compression but rather to other factors.
Choice B rationale
Placental uterine insufficiency leads to late decelerations rather than accelerations in fetal heart rate. Accelerations indicate adequate oxygenation, whereas insufficiency impairs fetal oxygenation.
Choice C rationale
Accelerations with fetal movement are a positive sign, indicating the fetus's well-being and appropriate response to stimuli. Normal accelerations last for at least 15 seconds and rise by 15 beats per minute.
Choice D rationale
Ominous signs in fetal monitoring include persistent late decelerations, severe bradycardia, and prolonged decelerations. Accelerations, however, are reassuring and do not warrant concern.

Choice A rationale
Rubella vaccination is contraindicated during pregnancy due to the live virus, which poses a risk to the fetus. Administration should occur postpartum to avoid congenital rubella syndrome in the infant.
Choice B rationale
This statement is correct as rubella vaccination should be deferred until after delivery. It avoids exposure to the live virus during pregnancy, protecting fetal health.
Choice C rationale
The Tdap vaccine is recommended during each pregnancy, typically between 27 and 36 weeks gestation, to boost maternal antibodies and provide passive immunity to the newborn.
Choice D rationale
The flu vaccine is recommended during pregnancy to protect both the mother and the baby from influenza. It reduces the risk of severe illness and complications from the flu.