A nurse detects a fetal heart rate of 175 beats per minute with decreased variability and late decelerations. What action should be taken first?

• A. Have the client change position
• B. Notify the healthcare provider immediately
• C. Apply oxygen by mask
• D. Prepare for cesarean birth

Answer: (A)

Interpreting fetal heart rate patterns and taking immediate actions to improve fetal oxygenation. A fetal heart rate of 175 with decreased variability and late decelerations signals possible uteroplacental insufficiency and fetal hypoxia. The first action is to reposition the mother to a left lateral position. This change improves uterine blood flow by relieving aortocaval compression and enhancing placental perfusion, which can lessen the impact of late decelerations and support better oxygen delivery to the fetus. After repositioning, proceed with additional measures such as providing oxygen, ensuring IV fluids, and notifying the provider, but the quickest, most direct step to start with is the position change to optimize perfusion.