All of the following should be performed when fetal heart monitoring indicates fetal distress except:

Fetal distress indicated on an electronic fetal monitor requires immediate nursing actions aimed at maximizing uteroplacental perfusion and fetal oxygenation, collectively known as intrauterine resuscitation. Key interventions include changing the maternal position (typically to a lateral position) to relieve aortocaval compression, administering supplemental oxygen via a non-rebreather mask at 8 to 10 L/min to elevate maternal blood oxygen concentration, and increasing intravenous fluid administration to expand maternal intravascular volume and enhance placental blood flow. Conversely, decreasing maternal fluids compromises intravascular volume and further reduces perfusion across the placenta, exacerbating fetal hypoxia. Therefore, decreasing maternal fluids is contraindicated during episodes of fetal distress and is the exception among the listed interventions.

Option A: Increasing maternal fluids expands intravascular volume and improves uteroplacental blood flow, which is an essential standard intervention for relieving fetal distress.

Option B: Administering supplemental oxygen increases maternal arterial oxygen concentration, enhancing oxygen delivery across the placenta to the compromised fetus during distress.

Option D: Turning the mother to a lateral position relieves aortocaval compression by the gravid uterus, improving maternal venous return, cardiac output, and placental perfusion.

1. American College of Obstetricians and Gynecologists (ACOG). (2019). ACOG Practice Bulletin No. 106: Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles. Obstetrics & Gynecology, 114(1), 192–202. https://doi.org/10.1097/AOG.0b013e3181aef26d

2. Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). (2018). Standards for Professional Nursing Practice in the Care of Women and Newborns (8th ed.). Executive Summary, Intrapartum Care Standards, pp. 12–18.

3. National Institute of Child Health and Human Development (NICHD). (2008). The 2008 National Institute of Child Health and Human Development Workshop Report on Electronic Fetal Monitoring. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 37(5), 510–515. https://doi.org/10.1111/j.1552-6909.2008.00284.x