A contraction stress test is ordered to a client at 35 weeks’ gestation. After half an hour, the client’s uterus begins to contract and the midwife observes three 40 - second - long contractions in a 10 - minute window. The client has two contractions within the next five minutes. The midwife notes that the fetal heart rate decreases toward the end of the contraction and afterward. This happends during more than 50% of the contractions. After stopping the oxytocin, which of the following is the next action of the midwife?
  1. Administer oxygen.
  2. Turn the client to the left side.
  3. Assess the client’s blood pressure.
  4. Refer the client to a physician for further evaluation.
Explanation
Answer: B - The next action of the midwife is to turn the client onto her left side after stopping the oxytocin. Turning to the left side alleviates vena cava compression, which improves the flow of oxygenated blood to the fetus. After turning, the midwife administers oxygen. The client will be referred to the physician after the initial interventions. Assessing the client’s blood pressure is an appropriate intervention, but it is not the priority action for the midwife.
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