After starting an intravenous infusion of Ringer's lactate with oxytocin, late fetal heart rate decelerations are noted. What is the essential action the nurse should take first?

In cases where late fetal heart rate decelerations are observed, the immediate concern is to address potential uteroplacental insufficiency, which can compromise fetal oxygenation. Pausing the oxytocin infusion is crucial because oxytocin can contribute to uterine contractions, and if these contractions are too strong or too frequent, they can reduce blood flow to the placenta. Stopping the infusion can help alleviate uterine pressure and potentially improve placental blood flow, which is essential for the well-being of the fetus.

In this scenario, the nurse prioritizes the immediate safety of the fetus by taking an action that directly addresses the most likely cause of the late decelerations. Other interventions, such as increasing the infusion rate or notifying the healthcare provider, while important, are not the immediate priority compared to addressing the potential hyperstimulation caused by oxytocin. Changing the position of the patient is also a beneficial action but should be considered alongside stopping oxytocin to optimize fetal well-being. The first step is to alleviate the potential source of distress by pausing the medication that may be exacerbating the situation.