Reduced or absent fetal movement may indicate decreased fetal energy expenditure in response to hypoxemia or fetal demise. A single episode does not diagnose fetal compromise, but it must be assessed promptly because movement is one of the client’s most important warning signs. Fetal tachycardia may occur when the fetus responds to stress through sympathetic activation. It can also occur with maternal fever, chorioamnionitis, dehydration, beta-agonist medications, or fetal anemia. Tachycardia becomes more concerning when variability decreases or decelerations appear. Late decelerations occur when uteroplacental oxygen transfer is inadequate during contractions. Because the deceleration begins after the contraction starts and recovers after the contraction ends, it suggests delayed fetal response to reduced oxygenation. Variable decelerations occur with cord compression. The umbilical vein is compressed first, lowering fetal preload. With more severe compression, umbilical arteries are affected, fetal blood pressure rises, and vagal stimulation causes abrupt fetal heart rate drops. Absent fetal heart tones may suggest fetal demise, but the RN must first rule out equipment error, maternal heart rate confusion, fetal position, gestational age limitations, or transducer placement issues. Definitive...