Question

At 9:00 a.m., the OB nurse assesses fetal station at 0. The laboring woman has strong, regular contractions. At 10:30 a.m., the nurse again assesses fetal station at 0. What action by the nurse is best?

A. Document the findings and continue to assess frequently.
B. Encourage the woman to bear down during contractions.
C. Increase the womans IV fluid rate and reassess in 30 minutes.
D. Inform the provider and prepare for possible cesarean delivery.

Answer 1

The best action is to inform the provider because no progression in the fetal station during strong, regular contractions may indicate a complication such as cephalopelvic disproportion or abnormal fetal positioning.

Step-by-step explanation:

If at 9:00 a.m., the OB nurse assesses fetal station at 0 and at 10:30 a.m., the nurse again assesses fetal station at 0 with the laboring woman having strong, regular contractions, the best action by the nurse is to inform the provider. Given that there has been no progression in the descent of the fetus (station), despite strong contractions over 1.5 hours, it may warrant a clinical reassessment to determine if there are underlying issues such as cephalopelvic disproportion (CPD) or abnormal fetal positioning. It's not appropriate to encourage the woman to bear down during contractions when the fetal station is at 0 because this indicates that the vertex of the fetus's head is at the level of the ischial spines and not low enough in the pelvis to warrant pushing. Increasing IV fluids is not directly related to fetal descent, and a cesarean delivery may not yet be indicated without further clinical assessment. Therefore, preparing for possible cesarean delivery might be premature without the provider's evaluation, but notifying them is important.