Editing Maternal and Newborn Nursing – RN Practice Questions (section)

==Question 14==
A nurse identifies a Category III fetal heart rate tracing in a client at 38 weeks in active labor. Which interventions should the nurse implement? '''Select all that apply.'''
# Reposition the client to a lateral position
# Discontinue the oxytocin infusion
# Administer an IV bolus of lactated Ringer solution
# Place the client in a supine position to obtain a clearer tracing
# Notify the provider and prepare for possible expedited birth
# Perform a vaginal examination to assess for cord prolapse and rapid descent

'''Answer:''' 1, 2, 3, 5, 6 (A, B, C, E, F).

''Rationale:'' Category III tracings (absent variability with recurrent late or variable decelerations or bradycardia, or a sinusoidal pattern) are associated with abnormal fetal acid-base status and require prompt intrauterine resuscitation and preparation for delivery. Lateral positioning relieves aortocaval compression and often relieves cord compression, stopping oxytocin restores placental perfusion between contractions, a fluid bolus supports maternal circulating volume and corrects hypotension, a vaginal examination rules out a treatable mechanical cause, and the provider must be notified. Option 4 is wrong and harmful: the supine position compresses the inferior vena cava and further reduces uteroplacental perfusion.