The 40-week-gestation patient is brought to the emergency department in active labor. Which assessment alerts the nurse to an impending emergency?

A 60-year-old patient never received a varicella vaccine and does not remember ever having chickenpox. However, you notice several ulcerated scars that look like scars from chickenpox. You anticipate an order for which of the following?

The nurse is caring for a G3P0 female at 40 weeks estimated gestational age in the second stage of labor. The patient does not have an epidural in place. After how many hours does the nurse contact the provider to report a prolonged second stage of labor?