Two hours ago, the 39-weeks'-gestation patient was 3 cm dilated, 40% effaced, and +1 station. Frequency of contractions was every five minutes with duration 40 seconds and intensity 50 mmHg. The current assessment is 4 cm dilated, 40% effaced, and +1 station. Frequency of contractions is now every three minutes with 40-50 seconds' duration with intensity of 40 mmHg. The priority intervention would be:

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Quizplus · Accepted Answer

The patient is showing slow progress in labor (only 1 cm dilation over two hours) with less effective contractions (decreased intensity from 50 mmHg to 40 mmHg), indicating a potential need for augmentation with oxytocin. Assessing for cephalopelvic disproportion (CPD) is important before starting oxytocin to ensure there are no mechanical obstacles to vaginal delivery. The patient is not in preterm labor (39 weeks' gestation), does not require oxygen based on the information provided, and the decision for an epidural is not directly related to the progress of labor.

Two Hours Ago, the 39-Weeks'-Gestation Patient Was 3 Cm Dilated