While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring

Question

after the peak of the con-traction. The nurse's first priority is to: a. Change the woman's position.
b. Notify the care provider.
c. Assist with amnioinfusion.
d. Insert a scalp electrode.

Answer 1

A

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A Late decelerations may be caused by maternal supine hypotension syndrome. They usually are corrected when the woman turns on her side to displace the weight of the gravid uterus from the vena cava.
B If the fetus does not respond to primary nursing interventions for late decelera-tions, the nurse would continue with subsequent intrauterine resuscitation meas-ures, including notifying the care provider.
C An amnioinfusion may be used to relieve pressure on an umbilical cord that has not prolapsed. The FHR pattern associated with this situation most likely reveals variable deceleration.
D A fetal scalp electrode would provide accurate data for evaluating the well-being of the fetus; however, this is not a nursing intervention that would alleviate late decelerations, nor is it the nurse's first priority.