A labor and delivery nurse is caring for a client in active labor. The fetal monitor shows late decelerations. The nurse should first

  1. place the client in high-Fowler’s position in preparation to push.
  2. place the client in left lateral recumbent position.
  3. increase the rate of IV Pitocin.
  4. call the physician and report fetal distress.
Number 2 is correct.
Rationale: The nurse’s priority is to increase oxygen to the fetus. The fastest way for the nurse to accomplish this is by turning the mother on her left side. The nurse should then stop the Pitocin drip and administer oxygen. A high-Fowler’s position could impede the blood supply to the fetus. Increasing IV Pitocin would cause stronger contractions that would also put the fetus at risk for compromised blood flow. The nurse should contact the physician after intervening with the mother and fetus.