During the second stage of labor, what should a nurse do for a client experiencing shoulder dystocia?

In the context of shoulder dystocia, which occurs when the fetal shoulder becomes lodged behind the mother's pelvic bone during delivery, performing the McRoberts maneuver is a critical intervention. This maneuver involves positioning the mother by flexing her knees to her chest. This position changes the pelvic angle, often helping to create more space for the shoulder to pass through the pelvic inlet.

The McRoberts maneuver is not only a non-invasive technique but also highly effective in resolving shoulder dystocia in many cases. By utilizing this method, it can reduce the time to delivery, lowering the risk of complications for both the mother and the infant. It is an essential skill for nurses and healthcare providers to know because timely action can significantly impact the outcomes of labor and delivery where shoulder dystocia is present.

Other interventions mentioned, such as encouraging the client to push harder or administering vaginal medications, may not effectively address the immediate needs of a client with shoulder dystocia. Providing intravenous fluids might be necessary for hydration in labor but does not directly resolve the impaction of the shoulder. The McRoberts maneuver is the most appropriate, evidence-based response to this urgent obstetric situation.