If a 32-year-old pregnant patient states "I have been in labor for 1 hour and my water broke," what should be your next action?

The most appropriate next action in this scenario is to assess for crowning. When a pregnant patient indicates that she has been in labor for an hour and her water has broken, it is important to evaluate the progress of labor. Crowning refers to the stage when the baby's head is visible at the vaginal opening during delivery. This assessment helps determine how far along the patient is in the labor process and whether a delivery is imminent.

Understanding whether crowning is present is critical for making informed decisions about the necessity and urgency of further actions, such as assisting in delivery or transporting to a hospital. If crowning is observed, that indicates the baby is close to being delivered, which may necessitate immediate delivery support. Conversely, if crowning is not present, then transport to the hospital may still be appropriate, depending on the progression of labor.

Assessing for crowning enables the healthcare provider to respond appropriately to the patient's needs based on the situation at hand, ensuring both the safety of the mother and the baby.