A nurse is assessing a client at 38 weeks gestation who reports reduced fetal movement today compared to usual. What is the PRIORITY nursing action?

DECREASED FETAL MOVEMENT (DFM) is a significant obstetric concern that requires PROMPT assessment. Fetal movement is an indicator of fetal wellbeing — the fetus moves in response to stimuli and as a sign of adequate oxygenation. NORMAL FETAL MOVEMENT: increases from about 28 weeks; most mothers notice consistent patterns by the third trimester; average 10 movements per 2-hour period (kick counts); fetal sleep cycles of 20-40 minutes (normal periods of less movement). SIGNIFICANCE OF DECREASED MOVEMENT: DFM can precede fetal death by hours to days; causes include: umbilical cord compression; placental insufficiency; fetal hypoxia; oligohydramnios (low amniotic fluid); intrauterine growth restriction (IUGR); fetal anomalies; acute fetal distress; sedating medications taken by mother. IMMEDIATE NURSING ACTIONS: notify provider/RN IMMEDIATELY — this is not a 'watch and wait' situation at 38 weeks; FETAL HEART RATE MONITORING: apply external fetal monitor (NST — non-stress test); assess FHR baseline, variability, presence of accelerations; POSITION: lateral position (left lateral preferred) to maximize uterine blood flow; SUPPLEMENTAL OXYGEN may be applied while monitoring; PROVIDER ASSESSMENT: physician/midwife will evaluate and may order biophysical profile (BPP) or other assessment. KICK COUNTS (normally taught as preventive): 10 movements in 2 hours is reassuring; if she can't count 10 movements in 2 hours → call provider immediately. WHY NOT REASSURE: at term, decreased fetal movement is not 'normal' and always requires evaluation before reassurance can appropriately be given; false reassurance of a genuinely compromised fetus can lead to preventable fetal death.