A nurse is caring for a client in active labor.

The nurse identifies tachysystole and late decelerations with each contraction.

The nurse performs intrauterine resuscitation interventions, including repositioning the client, initiating an IV fluid bolus, and applying oxygen.

After the stated interventions, the nurse continues to observe tachysystole and recurrent late decelerations.

Which medication does the nurse anticipate administering to reduce uterine activity?

Choice A rationale
• The non-stress test (NST) is reactive, indicating normal fetal heart rate patterns with adequate accelerations.
• The ultrasound shows normal amniotic fluid index and fetal movements, with no abnormalities detected.
• The client has no significant medical history and is generally feeling well.
These findings suggest that the fetus is currently well, and there is no immediate need for further intervention. However, the client should be instructed to monitor fetal movements at home and return if there are any concerns or if decreased fetal movement persists. This approach balances the need for vigilance with the reassurance provided by the normal test results.
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Choice B rationale
Continuous fetal monitoring is typically reserved for cases where there is a significant concern for fetal distress or other complications. In this case, both the non-stress test (NST) and ultrasound results are normal, indicating that the fetus is currently well. Therefore, continuous monitoring in a hospital setting is not necessary.
Choice C rationale
An immediate cesarean section is a major surgical procedure that is usually performed when there is an urgent risk to the mother or baby. Given the normal NST and ultrasound findings, there is no indication of fetal distress or other complications that would warrant such an intervention at this time.
Choice D rationale
Corticosteroids are given to enhance fetal lung maturity in cases where preterm delivery is anticipated, typically before 34 weeks of gestation. Since the client is already at 35 weeks and there is no indication of imminent preterm labor or other complications, administering corticosteroids is not necessary.

Choice A rationale
Late decelerations are a sign of uteroplacental insufficiency and fetal hypoxia. They occur after the peak of a contraction and indicate that the fetus is not receiving enough oxygen. This requires immediate intervention to improve fetal oxygenation and prevent fetal distress.
Choice B rationale
Variability in fetal heart rate of 12 bpm is considered moderate variability, which is a reassuring sign of fetal well-being. It indicates that the fetus has a healthy autonomic nervous system and is not in distress.
Choice C rationale
Accelerations in fetal heart rate are also a reassuring sign. They indicate that the fetus is well-oxygenated and responding appropriately to stimuli. No intervention is needed for accelerations.
Choice D rationale
A baseline fetal heart rate of 140 bpm is within the normal range (110-160 bpm) and does not indicate any immediate concern. It is a sign of a healthy, well-oxygenated fetus.