A nurse is monitoring a woman who is receiving oxytocin (Pitocin) to induce labor. What action should the nurse take first when late decelerations appear?

• A. Stopping the oxytocin infusion
• B. Notifying the nurse-midwife or health care provider
• C. Checking the woman's blood pressure and pulse
• D. Increasing the intravenous rate of the nonadditive solution

Answer: (A)

Late decelerations reflect fetal hypoxia from reduced placental perfusion, often worsened by excessive uterine activity. The immediate priority is to reduce that activity by stopping the oxytocin infusion. Doing so helps lessen contraction frequency and intensity, which can improve placental blood flow and fetal oxygenation. After stopping Pitocin, reassess the situation and continue with stabilizing steps such as repositioning the mother to the left side, providing oxygen, and ensuring adequate IV fluids, while promptly notifying the health care provider for further orders. While monitoring vital signs is essential, it is the cessation of the oxytocin that directly targets the cause of late decelerations and has the quickest potential to improve fetal status.