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Which action would the nurse take when a 15-beat-per-minute acceleration of the fetal heart rate above the baseline occurs during a contraction?

1. Call the practitioner to prepare for an imminent birth.
2. Turn the mother on her left side to increase venous return.
3. Record the fetal response to contractions and continue to monitor the heart rate.
4. Document the fetal heart rate abnormality and monitor the fetal heart rate continuously.

Answer :

Final answer:

The nurse should record the fetal response to contractions and continue to monitor the heart rate when a 15-beat-per-minute acceleration of the fetal heart rate occurs during a contraction, as this is considered a normal, reassuring sign of fetal well-being.

Explanation:

If a 15-beat-per-minute acceleration of the fetal heart rate occurs during a contraction, the appropriate action for a nurse would be to record the fetal response to contractions and continue to monitor the heart rate. Such accelerations are generally considered reassuring and indicate good fetal oxygenation and a healthy autonomic nervous system response of the fetus to the stress of contractions. Therefore, documenting the heart rate and continuing to monitor are key, rather than suggesting an imminent birth or marking it as an abnormality that requires continuous monitoring. It is a normal physiological response, and in the absence of other signs of fetal distress or other abnormal changes, no immediate emergency intervention is typically required.

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