medium · NCLEX-RN Health Promotion and Maintenance

During the second stage of labor for Morgan, the fetal head is delivered, but then it tightly retracts against the perineum (turtle sign).

Which intervention should the nurse implement first?

  1. Notify the neonatal resuscitation team to attend the delivery, at this point in care.
  2. Apply firm fundal pressure to help expel the infant, for this client, in this situation.
  3. Prepare for an immediate vacuum-assisted delivery
  4. Assist the client into the McRoberts maneuver by flexing the thighs against the abdomen

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