A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit.

The fetal heart rate has been normal.

Contractions are 10 to 15 minutes apart, 20 to 30 seconds in duration, and of mild intensity.

Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact.

The nurse should expect the woman to be:

Choice A rationale
Accelerations with moderate variability indicate fetal well-being and responsiveness to the uterine environment, requiring documentation of normal findings and reassurance to the mother.
Choice B rationale
There is no need to immediately call the midwife or doctor, as accelerations with moderate variability are positive indicators of fetal health and do not suggest any issues.
Choice C rationale
Taking maternal vital signs and advising bed rest is unnecessary because the observed accelerations and variability show that the fetus is not experiencing distress, negating the need for such interventions.
Choice D rationale
Repositioning the mother and checking the monitor for changes is unnecessary, given that accelerations with moderate variability already indicate a well-oxygenated and responsive fetus, not requiring any adjustments.

Choice A rationale
Placental insufficiency can cause late decelerations in fetal heart rate due to decreased blood flow, but it typically shows a gradual decrease rather than the abrupt patterns seen here.
Choice B rationale
Abruption usually presents with painful vaginal bleeding and a tender uterus, rather than specific changes in fetal heart rate patterns like those described in the question.
Choice C rationale
Head compression results in early decelerations, which appear as a mirror image of contractions, but these are not sudden drops in heart rate typically seen in cord compression.
Choice D rationale
Cord compression leads to variable decelerations characterized by sudden drops in fetal heart rate, caused by temporary reduction in oxygen flow to the fetus. This matches the tracing pattern described.