The nurse reviews the client's laboratory results. Exhibits SELECT words from the choices below to fill in each blank in the following sentence. The nurse should anticipate a provider's prescription for ____________ and _______________.

Rationale for correct choices • oxytocin: The client is term, contracting regularly, and already 3 cm dilated, indicating early active labor progression. Oxytocin may be anticipated to augment labor when contractions are present but not yet efficient. The presence of infection risk (fever, malodorous discharge) also increases the need to progress labor toward delivery. • nalbuphine: The client reports pain that increases to 8 during contractions, indicating a need for pharmacologic analgesia. Nalbuphine is an opioid analgesic used in labor for moderate to severe pain and is appropriate for intrapartum pain management. It can be anticipated when the client requests stronger pain relief before progression to active labor. Rationale for incorrect choices • magnesium sulphate: This medication is used for seizure prophylaxis in preeclampsia or for neuroprotection in preterm labor. The client’s blood pressure is within normal range, and gestation is 38 weeks, so there is no indication for magnesium sulfate. • misoprostol: Cervical ripening is not required because the cervix is already 3 cm dilated with active contractions. Misoprostol would not be indicated when labor is already progressing, especially in the presence of suspected infection, where accelerating delivery is preferred. • hydralazine: Hydralazine is an antihypertensive used for severe hypertension in pregnancy. The client’s blood pressure is 128/82 mm Hg, which does not indicate hypertensive management.