Question

During auscultation of the fetal heart rate (FHR) during labor, the nurse assesses a rate of 50 beats/minute. Which actions does the nurse take first?

A. Turns the client on the right side, opens the IV line, and calls the healthcare provider.
B. Turns the client on the left side, administers oxygen by nasal cannula, and assures IV access.
C. Places the client in a semi-Fowler's position, provides ice, and calls the healthcare provider.
D. Places the client in Trendelenburg position, administers oxygen, and forces fluids.

Answer 1

The nurse should turn the client on the left side, administer oxygen, and assure IV access in response to a fetal heart rate of 50 beats/minute during labor.

Step-by-step explanation:

The nurse should take immediate action to address the fetal heart rate (FHR) of 50 beats/minute during labor. The correct course of action would be to turn the client on the left side, administer oxygen by nasal cannula, and assure IV access.

Turning the client on the left side helps to increase blood flow to the placenta and improve fetal oxygenation. Administering oxygen by nasal cannula helps to provide oxygen to the baby. Assuring IV access ensures that fluids and medications can be administered if necessary.