A patient at 41 weeks' gestation is undergoing an induction of labor with an IV administration of oxytocin (Pitocin). The fetal heart rate starts to demonstrate a recurrent pattern of late decelerations with moderate variability
What is the nurse's priority action?
a. Stop the infusion of Pitocin.
b. Reposition the patient from her right to her left side.
c. Perform a vaginal exam to assess for a prolapsed cord.
d. Prepare the patient for an emergency cesarean section.
ANS: A
There are multiple reasons for late decelerations. Address the probable cause first, such as uterine hyperstimulation with Pitocin, to alleviate the outcome of late decelerations. Repositioning can increase oxygenation to the fetus but does not address the cause of the problem. Variable decelerations are more often seen with a prolapsed cord. In the presence of moderate variability, the fetus continues to have adequate oxygen reserves. The presence of two or more nonreassuring fetal heart rate patterns increases the level of concern.
You might also like to view...
The American Cancer Society (ACS) and American Institute of Cancer Research (AICR) have both made recommendations for eating properly to prevent cancer. Which of the following are true for both guidelines? Select all that apply
A) Do not use supplements to protect against cancer. B) Choose whole grains instead of refined grains. C) Eat a variety of food with emphasis on plant sources. D) Limit the intake of red meats.
The home health nurse observes a client's 3-month supply of insulin vials are not refrigerated. Which action should the nurse take?
A. Instruct the client that the insulin should be stored away from direct sunlight or excessive heat. B. Have the client discard the vials. C. Instruct the client to label each vial with the date when opened. D. Instruct the client that unopened bottles can be stored for up to 3 months
Which is an accurate definition of impairment?
a. A problem in body function or structure b. A restriction or inability to perform an activity in a normal manner c. A defect that affects society on a macro level d. A disadvantage resulting from a disability that prevents fulfillment of an expected role
Which ethnic group is at risk for carrying the sickle cell trait?
a. Ashkenazi Jewish ancestry b. Northern European ancestry c. African ancestry d. Mexican ancestry