A laboring client is at 10 cm dilation. What would the nurse do next?

Choice A rationale Assessing for the need for pain medication is not appropriate at 10 cm dilation. At this stage, the client is in the second stage of labor, which is characterized by pushing and the birth of the baby. The use of pain medication at this point could potentially suppress the mother’s urge to push and prolong labor, so it is generally not a priority. Choice B rationale Administering oxytocin is not the correct action. Oxytocin is a hormone used to induce or augment labor. A client who has reached 10 cm dilation is in the second stage of labor and no longer needs augmentation. Administering oxytocin at this stage could increase the risk of uterine hyperstimulation and fetal distress. Choice C rationale The client's dinner is irrelevant at this stage of labor. A client at 10 cm dilation is in the second stage of labor, which is the pushing phase leading to birth. Oral intake is typically restricted during active labor to prevent the risk of aspiration if general anesthesia is required, and a meal is not a consideration. Choice D rationale When the client reaches 10 cm dilation, the cervix is fully dilated and effaced, signifying the end of the first stage of labor. This is the transition to the second stage of labor, which involves pushing and delivery. The nurse's next action is to prepare for this stage by setting up sterile equipment, positioning the client, and providing coaching for pushing efforts.