Question

A nurse assessing a woman in labor notes late decelerations on the fetal monitor and documents contractions occurring every 1 to 2 minutes. Oxytocin (Pitocin) is being infused IV, and oxygen is being delivered at 8 L/min per mask. The woman is positioned on her left side. What action by the nurse takes priority?

A. Discontinue the oxygen.
B. Increase the oxytocin rate.
C. Assist the woman to a supine position.
D. Stop the oxytocin infusion.

Answer 1

The action by the nurse that takes priority is to stop the oxytocin (Pitocin) infusion.

Step-by-step explanation:

The action by the nurse that takes priority in this situation is to stop the oxytocin (Pitocin) infusion .Late decelerations on the fetal monitor indicate fetal distress, which can be caused by inadequate oxygen supply to the fetus. Contractions occurring every 1 to 2 minutes may indicate hyperstimulation, which can further compromise fetal oxygenation. Stopping the oxytocin infusion will help alleviate the hyperstimulation and give the fetus a chance to recover. It is important to ensure adequate oxygenation by maintaining the oxygen mask and assisting the woman to a side-lying position if necessary.