Two hours ago, a patient at 39 weeks' gestation was 3 cm dilated, 40% effaced, and +1 station. Frequency of contractions was every 5 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 3 minutes with 40-50 seconds' duration and intensity of 40 mmHg. The priority intervention would be:

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Quizplus · Accepted Answer

The priority intervention in this situation would be to start oxytocin after assessing for cephalopelvic disproportion (CPD) to help progress labor as the patient is already at term (39 weeks) and has demonstrated progress in dilation, effacement, and station. Terbutaline is used to stop preterm labor, which is not relevant in this case. Oxygen delivery may be indicated if the patient is experiencing hypoxia or fetal distress, but this information is not given in the scenario. Epidural administration may be appropriate to treat pain, but it is not the priority intervention in this situation.

Two Hours Ago, a Patient at 39 Weeks' Gestation Was