When 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 con-traction, with the nadir of the decelerations occurring
after the peak of the contraction. The nurse's first priority is to: 1. change the woman's position.
2. notify the care provider.
3. assist with amnioinfusion.
4. insert a scalp electrode.
1
1. Correct. Late decelerations may be caused by maternal supine hypotension syndrome. They are usually corrected when the woman turns onto her side to displace the weight of the gravid uterus off the vena cava.
2. Incorrect. If the fetus does not respond to primary nursing interventions for late decelera-tions, the nurse would continue with subsequent intrauterine resuscitation measures including notifying the care provider.
3. Incorrect. An amnioinfusion may be used to relieve pressure on a nonprolapsed umbilical cord. The fetal heart rate pattern associated with this situation mostly likely reveals variable deceleration.
4. Incorrect. A fetal scalp electrode would provide accurate data to evaluate fetal well-being, but is not a nursing intervention that would alleviate late decelerations, nor is it the nurse's first priority.
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