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A nurse is caring for a client who is undergoing an external nonstress test at 40 weeks of gestation and notes variable decelerations on the fetal monitor tracing that are unresponsive to interventions such as repositioning and oxygen administration.
Which of the following actions should the nurse take next?
Prepare the client for an amnioinfusion. An amnioinfusion is a procedure that adds fluid to the uterus during labor to relieve cord compression and improve fetal condition. Variable decelerations on the fetal monitor tracing are a sign of cord compression and fetal distress. If repositioning and oxygen administration do not resolve the decelerations, an amnioinfusion may be indicated.
Applying an internal fetal scalp electrode does not address the cause of variable decelerations, which is cord compression. An internal fetal scalp electrode is used to monitor the fetal heart rate more accurately, but it does not improve fetal oxygenation or prevent cord compression.
Administering IV fluid bolus to the client may help increase maternal blood volume and placental perfusion, but it does not directly increase amniotic fluid volume or relieve cord compression.
Discontinuing oxytocin infusion if present may reduce uterine contractions and decrease cord compression, but it may also prolong labor and increase the risk of infection or fetal compromise. Oxytocin infusion should only be discontinued if there are signs of uterine hyperstimulation or fetal intolerance.
Prepare the client for an amnioinfusion. An amnioinfusion is a procedure that adds fluid to the uterus during labor to relieve cord compression and improve fetal condition. Variable decelerations on the fetal monitor tracing are a sign of cord compression and fetal distress. If repositioning and oxygen administration do not resolve the decelerations, an amnioinfusion may be indicated.
Choice B is wrong because applying an internal fetal scalp electrode does not address the cause of variable decelerations, which is cord compression.
An internal fetal scalp electrode is used to monitor the fetal heart rate more accurately, but it does not improve fetal oxygenation or prevent cord compression.
Choice C is wrong because administering IV fluid bolus to the client may help increase maternal blood volume and placental perfusion, but it does not directly increase amniotic fluid volume or relieve cord compression.
Choice D is wrong because discontinuing oxytocin infusion if present may reduce uterine contractions and decrease cord compression, but it may also prolong labor and increase the risk of infection or fetal compromise. Oxytocin infusion should only be discontinued if there are signs of uterine hyperstimulation or fetal intolerance.