Practice Quiz

CNM Certified Nurse Midwife

Category - Intrapartum

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A nurse midwife is monitoring a client in labor who is receiving intravenous oxytocin. The fetal heart rate monitor tracing reveals decelerations occurring 35 seconds after the onset of each contraction and continuously past the end of the each contraction. Which of the following is the priority action of the nurse midwife?
  1. Change the client’s position to side-lying position.
  2. Position the client to Trendelenburg position.
  3. Stop the administration of oxytocin.
  4. Administer oxygen.
Explanation
Answer: C - The priority action of the nurse midwife is to stop the administration of oxytocin. The client is demonstrating late decelerations, indicating the occurrence of uteroplacental insufficiency. If the client is receiving oxytocin at this time, it is most important to stop the infusion first before starting with the other interventions. The nurse midwife should change the client’s position to the side-lying position and administer oxygen after adjusting the rate of oxytocin infusion. The Trendelenburg position is indicated if the client has prolapsed cord.
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