What is the nurse's priority intervention for a client in active labor with a fetal heart rate below 70 beats per minute?

In the scenario of a client in active labor with a fetal heart rate below 70 beats per minute, the primary concern is ensuring adequate oxygenation and improving blood flow to the fetus. A fetal heart rate below 70 indicates potential fetal distress, and immediate interventions are necessary to stabilize the situation.

Positioning the client on her left side is critical because this position can help relieve pressure on the vena cava, which improves uteroplacental blood flow and can enhance fetal perfusion. Additionally, administering oxygen to the mother can increase the amount of oxygen available to the fetus, further helping to counteract the effects of any fetal distress.

Together, these actions can quickly address the issue of low fetal heart rate, making them the priority intervention. The other options, while potentially relevant in a different context, do not provide the immediate support needed in emergency situations where fetal heart rate is significantly low. Calling the provider may be necessary, but it’s not the first action to take; managing the mother’s position and providing supplemental oxygen are immediate and directly address the fetal distress. Similarly, adjusting IV rates or placing the client in the lithotomy position does not prioritize fetal oxygenation and wellbeing in the same way that repositioning and administering oxygen do.