The nurse notes a nonreassuring pattern of the fetal heart rate. The mother is already lying on her left side. What nursing action is indicated?

Choice A: Change her position to the right side

Changing the mother’s position to the right side can sometimes help improve fetal oxygenation by relieving pressure on the vena cava. However, since the mother is already lying on her left side, which is typically the preferred position to optimize blood flow, changing to the right side may not be as effective .

Choice B: Place a wedge under the left hip

Placing a wedge under the left hip is a common intervention to improve uteroplacental blood flow. This position helps to tilt the uterus off the vena cava, enhancing venous return and improving cardiac output, which can positively affect fetal oxygenation. This is why it is the correct answer.

Choice C: Lower the head of the bed

Lowering the head of the bed can help increase blood flow to the upper body and brain, but it does not specifically address the issue of improving uteroplacental blood flow. This action is less targeted for resolving nonreassuring fetal heart rate patterns.

Choice D: Place the mother in a Trendelenburg position

The Trendelenburg position, where the mother is laid flat on her back with her feet elevated higher than her head, is generally used to treat hypotension or to improve venous return in cases of shock. However, it is not typically recommended for nonreassuring fetal heart rate patterns as it can increase pressure on the diaphragm and reduce respiratory efficiency.

Choice A reason:

If the client reports frequent uterine contractions , it is not indicative of a distended bladder. Postpartum uterine contractions are normal and necessary to help the uterus return to its pre-pregnancy size.

Choice B reason:

The fundus (the top portion of the uterus being palpable to the right of the midline suggests a distended bladder. A full bladder can displace the uterus, causing the fundus to deviate from the midline.

Choice C reason:

Having less than 2.5 cm of rubra lochia on a perineal pad is related to the amount of vaginal discharge after birth and does not provide information about bladder distention.

Choice D reason:

The client's report of increased thirst may indicate dehydration or the body's response to fluid loss during childbirth but is not directly related to bladder distention.