When a multigravida client's membranes rupture spontaneously with meconium-stained fluid, what should the nurse do first?

Monitoring the fetal heart rate continuously is critical when a multigravida client experiences a spontaneous rupture of membranes with meconium-stained fluid. The presence of meconium can indicate fetal distress, and continuous fetal heart rate monitoring allows the nurse to detect any signs of fetal compromise, such as variable decelerations or other abnormalities in heart rate patterns that may arise due to meconium aspiration or other complications.

In situations where meconium is present, there is an increased risk for potential complications, which makes immediate assessment of the fetal condition essential. Continuous monitoring provides real-time data about the fetal status, allowing for timely interventions if any concerning changes occur. This early detection can be crucial in preventing adverse outcomes for the fetus, guiding subsequent nursing actions or physician interventions.

While other interventions, such as assessing cervical dilation and effacement, may also be important for overall labor management, they do not take precedence over ensuring the wellbeing of the fetus in the context of meconium-stained amniotic fluid. Thus, continuous monitoring is correctly identified as the priority action in this scenario.