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Daily #22 · Fluid & Electrolytes · Archive

NCLEX-RN® question of the day

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The question

A primigravida at 39 weeks gestation is admitted in active labor with cervical dilation of 5 cm. The fetal monitor shows a fetal heart rate (FHR) baseline of 145 bpm with moderate variability. Suddenly, the nurse notes a FHR deceleration that begins at the peak of a uterine contraction, mirrors the contraction's shape, and returns to baseline after the contraction ends. The client is positioned on her left side and oxygen is being administered. Which action should the nurse take next?

  1. Increase the IV fluid infusion rate and notify the primary health care provider of a non-reassuring FHR pattern.
  2. Continue current interventions and monitor closely, as this pattern is consistent with a late deceleration requiring primary health care provider notification.
  3. Prepare for immediate cesarean delivery due to uteroplacental insufficiency.
  4. Document the finding as a late deceleration and continue monitoring, as this is an expected pattern.

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