Final answer:
The nurse should prioritize the client's respiratory rate, followed by contraction pattern, and then fetal heart rate variability according to the Apgar score criteria. Proper sequence and timely intervention based on these priorities can improve both maternal and newborn outcomes during the postpartum period.
Step-by-step explanation:
The assessment at 1800 by the nurse should prioritize the client's respiratory rate, followed by the contraction pattern, and then the client's fetal heart rate variability. These priorities are based on the Apgar score criteria, which emphasize the importance of heart rate and respiration, particularly in the immediate postpartum period. In this situation, the correct action for the nurse plan would be to first address any issues with respiration, as poor respiration can quickly lead to deteriorating conditions for both the mother and child.
For example, the nurse may notice an abnormal respiratory rate that could indicate distress, or variability in the fetal heart rate that requires immediate attention. To address these issues, the nurse might increase oxygen delivery, perform stimulation to encourage breathing, or adjust the mother's position. Following this, evaluating the contraction pattern is essential to ensure labor is progressing normally, and if needed, interventions such as adjusting the pitocin infusion may be made.
Therefore, the appropriate sequence from the options provided is as follows: The nurse should first address the client's resp rate, followed by the client's contraction pattern, and then the client's fetal heart rate variability, which corresponds to option (b).