Question

The nurse is monitoring a pt in the first stage of labor who is being induced. The RN identifies a FHR pattern of decelerations occuring AFTER the onset of each contraction & a return to the baseline well after the contractions occur. Which actions should the nurse take?

A) Change the patient's position
B) Administer oxygen to the patient
C) Increase the rate of the IV oxytocin infusion
D) Prepare for an emergency cesarean section

Answer 1

The nurse should promptly change the patient's position and administer oxygen due to the pattern of late decelerations in FHR indicating potential fetal distress. Actions like increasing oxytocin or preparing for an emergency C-section would follow based on the results of initial interventions.

Step-by-step explanation:

The nurse is monitoring a patient in the first stage of labor who is being induced and identifies a fetal heart rate (FHR) pattern of decelerations occurring after the onset of each contraction with a return to the baseline well after the contractions. This FHR pattern suggests late decelerations, which are a sign of uteroplacental insufficiency and may indicate fetal distress. The nurse's immediate actions should include:

1. Change the patient's position, preferably to the left lateral side, to improve blood flow to the uterus and fetus.
2. Administer oxygen to the patient, which may improve fetal oxygenation.

Considering these points, increasing the rate of the IV oxytocin infusion would not be appropriate as it might exacerbate the situation by causing more intense contractions leading to further reductions in blood flow to the fetus. Preparing for an emergency cesarean section would be a step to consider if the decelerations do not resolve with the initial interventions and the fetal distress continues.