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A patient is undergoing induction of labor with oxytocin infusion. The patient has an epidural for analgesia but continues to report feeling intense rectal pressure. To rule out imminent delivery, the nurse should assess the patient for which finding or findings?

A. Spontaneous rupture of membranes with meconium-stained fluid
B. Moderate to heavy vaginal bleeding
C. Increased bloody show, labial separation, and crowning
D. The patient's expression of urgency

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Final answer:

To check for imminent delivery, a nurse should assess for increased bloody show, labial separation, and crowning. Spontaneous rupture of membranes with meconium-stained fluid indicates fetal distress and should be addressed instantly. The patient's expression of urgency may also signal nearing delivery.

Step-by-step explanation:

To rule out imminent delivery for a patient experiencing intense rectal pressure during oxytocin-induced labor, the nurse should assess for signs such as increased bloody show, labial separation, and crowning.

These signs indicate that the baby's head is descending into the pelvis and nearing the vaginal opening, suggesting that delivery could occur soon. In this context, a spontaneous rupture of membranes with meconium-stained fluid could also point to a potential complication requiring immediate attention due to the implications of fetal distress.

However, moderate to heavy vaginal bleeding could indicate other serious conditions such as placental abruption or placenta previa and should be assessed urgently. Lastly, while the patient's expression of urgency can be subjective and influenced by pain and stress, it should not be overlooked as it may also be indicative of the baby's imminent arrival.

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