A nurse is caring for a client who is in labor. Exhibits Which of the following actions should the nurse take? Select (3) options.

Rationale: A. Antipyretics are used to reduce maternal fever, which can indirectly affect fetal heart rate. In this scenario, the client’s temperature is not elevated, so an antipyretic is not indicated. Late decelerations are not caused by maternal fever, so this intervention would not address the underlying problem. B. Elevating the fetal presenting part is relevant in umbilical cord prolapse, where pressure on the cord compromises fetal blood flow. There is no evidence of cord prolapse in this case. Late decelerations are caused by uteroplacental insufficiency, not cord compression, so this intervention is not appropriate. C. Side-lying positioning improves uteroplacental blood flow and reduces compression of the inferior vena cava, increasing oxygen delivery to the fetus. Repositioning is a first-line intervention for late decelerations and can immediately improve fetal oxygenation. This may involve left or right lateral positioning and sometimes using a wedge under the hip to tilt the uterus off major vessels. D. Oxytocin stimulates uterine contractions. Excessive uterine activity (hyperstimulation) can worsen uteroplacental insufficiency. Discontinuing oxytocin allows uterine relaxation, improving blood flow and oxygen delivery to the fetus. This is a priority intervention in the presence of late decelerations associated with induction or augmentation. E. Epidurals can cause maternal hypotension, which can contribute to fetal hypoxia. However, removing the epidural is not routinely indicated for late decelerations. Interventions focus on repositioning, IV fluids, and oxytocin management rather than removing anesthesia. F. Administering an IV fluid bolus or increasing the infusion rate improves maternal circulating volume, enhancing uteroplacental perfusion. This helps alleviate uteroplacental insufficiency, which is causing the late decelerations. IV fluid administration is a quick, noninvasive measure to stabilize fetal oxygenation.