What is the best nursing action to implement when late decelerations occur?

Choice A rationale Repositioning the patient to a lateral side (left or right) is the standard initial intervention to alleviate possible aortocaval compression (supine hypotension syndrome), which can decrease placental perfusion. Supine positioning should be avoided as it can exacerbate the underlying issue of decreased uterine blood flow. Choice B rationale Late decelerations are typically caused by uteroplacental insufficiency (decreased blood flow/oxygen to the fetus). Decreasing the flow of intravenous fluids can lead to maternal hypotension or hypovolemia, further compromising uterine blood flow and worsening the fetal oxygen status. IV fluids should be increased (bolus) to improve maternal hydration and placental perfusion. Choice C rationale Oxytocin causes uterine contractions, which temporarily decrease blood flow to the placenta during their peak. Increasing the oxytocin drip would intensify contractions, further compromising fetal oxygenation, thus contradicting the goal of improving uteroplacental perfusion. The oxytocin infusion should be discontinued or reduced immediately. Choice D rationale Increasing oxygen to 10 L/minute via a nonrebreather mask is a primary corrective measure for late decelerations. This action increases the maternal arterial oxygen saturation, thereby maximizing the oxygen concentration available for transfer across the placenta to the fetus, directly addressing the underlying issue of fetal hypoxia.