During labor, if a nurse observes variable decelerations on an external fetal monitor, what should the nurse do first?

In the context of labor and the observation of variable decelerations on an external fetal monitor, placing the client on her left side is a critical first action because it can help alleviate umbilical cord compression. Variable decelerations often indicate that the fetus may be experiencing reduced oxygen due to cord compression, which can happen when the umbilical cord becomes pinched during contractions.

By positioning the client on her left side, you improve uterine perfusion and relieve pressure on the cord, potentially stabilizing the fetal heart rate. This position can enhance blood flow to the placenta and the fetus, thereby improving oxygenation and mitigating the effects of the decelerations.

While other interventions like administering oxygen or increasing IV fluids can be important in managing labor complications, addressing the immediate physical factor of positional changes is critical in cases of variable decelerations. Preparing for imminent birth could also be necessary if there is a concern for fetal distress or other complications, but the priority is to resolve the underlying issue indicated by the variable decelerations.