If the fetal monitor demonstrates the following pattern, which action would the nurse perform first? (Click on paperclip if image is not showing).

Choice A rationale Preparing for a vaginal delivery is not the immediate first action. The fetal heart rate pattern indicates potential fetal distress, which needs to be addressed and corrected before any definitive decisions about the mode of delivery are made. The priority is to improve uteroplacental blood flow and fetal oxygenation. Choice B rationale Administering oxygen at 8 to 10 liters via nasal cannula may be a secondary intervention if turning the client is not effective. The primary cause of late decelerations is uteroplacental insufficiency. While oxygen can help, the initial and most effective intervention is to reposition the mother to improve blood flow. Choice C rationale Late decelerations, which are characterized by a gradual decrease in fetal heart rate after the peak of a contraction and a gradual return to baseline after the contraction has ended, are most often caused by uteroplacental insufficiency. Turning the client on their side, particularly the left side, relieves pressure on the vena cava, improving venous return to the heart, which in turn increases uteroplacental blood flow and fetal oxygenation. Choice D rationale Performing a vaginal exam to assess for the umbilical cord is the appropriate intervention for variable decelerations, not late decelerations. Variable decelerations are caused by umbilical cord compression. A vaginal exam would not address the underlying issue of uteroplacental insufficiency responsible for late decelerations.