A nurse is assisting with caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. Which of the following is the first action the nurse should identify that the registered nurse should take?

Late decelerations on the electronic fetal monitor indicate uteroplacental insufficiency, meaning the fetus is not receiving adequate oxygen from the placenta during uterine contractions. This is a nonreassuring fetal heart rate pattern that requires prompt intervention. The first and most immediate action is to reposition the client into the left lateral (left side-lying) position. This position relieves aortocaval compression caused by the gravid uterus pressing on the inferior vena cava, which improves venous return to the heart, increases cardiac output, and enhances uteroplacental perfusion. Additional interventions typically follow, including administering supplemental oxygen via face mask, increasing IV fluid infusion, discontinuing oxytocin if infusing, and notifying the provider. Inserting an IV catheter is important for fluid administration and medication access, but establishing IV access comes after repositioning, which is the fastest and most immediate intervention. Applying a fetal scalp electrode may improve monitoring accuracy but does not address the underlying cause of late decelerations. Performing a vaginal examination assesses cervical dilation and fetal presentation but does not directly treat uteroplacental insufficiency and would not be the first action in response to late decelerations.