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A client's membranes rupture while her labor is being augmented with an oxytocin infusion. A nurse observes variable decelerations in the fetal heart rate on the fetal monitor strip. What action should the nurse take next?

A client's membranes rupture while her labor is being augmented with an oxytocin infusion. A nurse observes variable decelerations in the fetal heart rate on the fetal monitor strip. What action should the nurse take next? Correct Answer Change the client's position

Concept:-

Note -> In such cases the position change in important because of cord compression risk 

Since the bag is ruptured there is risk of cord compression which is  threatening to life to new born.

  • Oxytocin in labor should be constituted by adding 10 IU oxytocin to 1 liter of 0.9% normal saline starting at an infusion rate of 1-5mU/min (6-30 ml per hour).
  • The infusion rate may be increased by 1-5mU/min (6-30ml/hour) every 15-30 minutes up to a maximum of 30mU/min (180 ml/hour).
  • Early decelerations of fetal heart sound are caused by compression of the fetal head during uterine contractions. This results in vagal response (a response that occurs when the vagus nerve is stimulated). The vagal response causes a drop in the fetal heart rate.
  • As early decelerations are not associated with decreased fetal oxygenation or metabolic acidosis, they do not require any treatment. To manage the condition client's position has to be changed.

Additional Information

      Late decelerations treatment and management 

  • Lie down in the left lateral, knee-chest, or right lateral position to relieve compression of the large vein (or vena cava) by your pregnant uterus.
  • Oxygen administration in response to late decelerations.

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