A nurse is caring for a laboring client who has reached the second stage of labor. Which nursing interventions are most appropriate during this stage? (Select All that Apply.)

A. Prepare for immediate delivery of the placenta: The placenta is typically delivered during the third stage of labor, not the second. Preparing for its delivery at this point is premature; the focus should remain on supporting the mother and monitoring the fetus as the baby is delivered first. B. Limit vaginal examinations to reduce risk of infection during contractions: Frequent vaginal exams increase the risk of introducing pathogens, especially after rupture of membranes. Limiting these assessments to essential times helps minimize infection risk. C. Provide emotional support and coaching to the client during pushing efforts: Emotional reassurance and coaching help reduce maternal anxiety and improve pushing effectiveness. Encouraging, calm communication supports maternal confidence and promotes smoother delivery. D. Assist the client into a position that maximizes comfort and fetal descent, such as semi-Fowler’s or side-lying: Maternal positioning enhances pelvic dimensions and facilitates fetal descent. Positions like semi-Fowler’s, squatting, or side-lying also improve comfort and maternal control during pushing. E. Encourage the client to push with contractions using controlled breathing and effort: Coordinating pushing with contractions maximizes uterine efficiency and conserves energy. Controlled breathing prevents hyperventilation and helps maintain steady oxygenation. F. Monitor fetal heart rate every 15 minutes or more frequently if indicated: Continuous or frequent fetal heart monitoring detects early signs of fetal distress. Regular assessment ensures timely intervention if complications such as bradycardia or decelerations occur during pushing