Immediately after spontaneous rupture of the membranes in labour, which nursing action has priority?
Correct answer: A. Assess the fetal heart rate
- A. Assess the fetal heart rate
- B. Offer the woman oral fluids
- C. Begin fundal massage
- D. Prepare the postnatal bed
Explanation
The fetal heart rate is checked immediately after membrane rupture because cord compression or cord prolapse can cause sudden fetal compromise. Fluids and bed preparation are less urgent than assessing fetal oxygenation.
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About Normal Labour and Delivery
Normal labour covers the onset and stages of labour, cervical effacement and dilatation, fetal lie and presentation, the cardinal movements, and maternal and fetal monitoring. It includes partograph use, pain relief, normal vaginal birth, active management of the third stage, placental assessment and immediate care after delivery.
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