Practice Quiz

CNM Certified Nurse Midwife

Category - Intrapartum

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A client is admitted to the labor and delivery unit. A nurse midwife is assessing the fetal heart tone monitor tracing and notes late decelerations. Which of the following is the most effective intervention?
  1. Administer oxygen through a face mask.
  2. Position the client in knee-chest position.
  3. Administer oxytocin.
  4. Document the findings and continue monitoring the client.
Explanation
Answer: A - The most effective action for the nurse midwife to take is to administer oxygen through a face mask. The client is most likely experiencing uteroplacental insufficiency, which usually results from decreased flow of oxygenated blood to the fetus during contractions. The client should be placed in the left side lying position to improve fetal circulation and oxygenation. Oxytocin increases uteroplacental insufficiency and should not be administered; it can aggravate or worsen fetal hypoxemia.
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