Final answer:
A nurse's plan of care for a patient in active labor at 39 weeks gestation should include fetal and maternal monitoring, pain management, and preparation for interventions like Pitocin to ensure a safe delivery.
Step-by-step explanation:
The care plan for a patient who is 39 weeks gestation and in active labor should focus on monitoring the labor progression and providing comfort and safety to the patient. The nurse should ensure regular monitoring of the fetus's heart rate and the mother's vital signs and contraction pattern. Supportive measures like pain management, encouragement and guidance during pushing, and preparation for possible interventions, such as the administration of Pitocin if labor progression stalls, are critical during this time. The goal is to facilitate a safe and healthy delivery for both the mother and the newborn.