In a prenatal clinic, a nurse is caring for a group of clients.

Which client should the nurse identify as having a contraindication for a contraction stress test?

Choice A rationale
Informing the client that the law requires them to name the fetus is not accurate. Laws vary by location, but most do not require parents to name a stillborn fetus. It is important to provide accurate information and support the parents in their decisions during this difficult time.
Choice B rationale
Limiting the amount of time the fetus is in the client’s room is not necessarily beneficial. Each family will have different needs and preferences when it comes to spending time with their stillborn baby. Some families may find comfort in holding and spending time with their baby, while others may prefer not to. The nurse should support the family’s decisions and provide compassionate care.
Choice C rationale
Instructing the client that an autopsy should be performed within 24 hours is not necessarily beneficial. The decision to perform an autopsy will depend on a variety of factors, including the parents’ wishes, the circumstances of the stillbirth, and local laws and regulations. It is important to provide the parents with information and support them in making this decision.
Choice D rationale
Providing the client with photos of the fetus can be a helpful part of the grieving process for some families. It allows them to remember their baby and can be a tangible reminder of the baby’s existence. However, this should be done based on the family’s wishes.

Choice A rationale
Administering oxygen helps improve oxygenation to the fetus and is the priority intervention for late decelerations. Oxytocin is commonly used for induction and augmentation of labor. Its influence is indirect via increased uterine activity, mostly due to increased frequency of contractions or baseline pressure (hypertonus). Increase in duration or amplitude of contractions can also lead to FHR changes. The FHR changes associated with oxytocin infusion may be caused by compression of the cord with contractions or by the reduction in placental perfusion due to increased intrauterine basal pressure and frequent contractions cutting off the blood supply to the placenta. Therefore, administering oxygen can help improve the oxygen supply to the fetus.
Choice B rationale
Instructing the client to bear down and push with contractions is not the appropriate action when the fetus is experiencing persistent late decelerations. This action is more associated with the active phase of labor and not with managing fetal distress.
Choice C rationale
Amnioinfusion is a procedure where a saline solution is instilled into the uterus during labor if there is low amniotic fluid, or thick meconium is present. It is not typically used in response to late decelerations in the FHR.
Choice D rationale
Placing the client in a supine position is not the correct action. The supine position can exacerbate a condition known as supine hypotensive syndrome, where the gravid uterus compresses the inferior vena cava, reducing venous return to the heart and cardiac output. This can potentially worsen fetal distress.