The nurse notes a pattern of the fetal heart rate decreasing after each contraction. What action should the nurse implement?

• A. Give 10 liters of oxygen via face mask.
• B. Prepare for an emergency cesarean section.
• C. Continue to monitor the fetal heart rate pattern.
• D. Obtain an oral maternal temperature.

Answer: (A)

When the fetal heart rate slows after contractions, this pattern points to late decelerations, which reflect uteroplacental insufficiency and potential fetal hypoxia. The immediate goal is to improve fetal oxygenation and placental perfusion. Administering high-flow oxygen via a face mask raises maternal blood oxygen levels, increasing the amount of oxygen available to the fetus and helping to counteract the hypoxic pattern.

Alongside this, position the mother to optimize blood flow to the placenta (often a left lateral position) and assess/adjust other factors that affect perfusion, such as stopping oxytocin if it’s infusing and ensuring adequate IV fluid intake as per protocol. Continuous fetal monitoring continues to guide steps and determine if delivery becomes necessary.

Simply continuing to monitor would not address the distress indicated by late decelerations. Preparing for an emergency cesarean is a contingency if the tracing remains nonreassuring despite initial interventions. Checking the maternal temperature is not directly addressing the fetal oxygenation problem.