Fetal Non-Stress Test (NST) > Maternal & Newborn
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Nursing interventions and follow-up
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is preparing to perform a nonstress test (NST) for a client who is at 36 weeks of gestation and reports decreased fetal movement.
Which of the following actions should the nurse take first?
Explanation
Explain the purpose, procedure, and possible outcomes of the test to the client.This is because the nurse should always obtain informed consent from the client before performing any procedure, and provide education and reassurance about the test.
Choice A is wrong because applying conduction gel to the client’s abdomen is not the first action the nurse should take.The nurse should first explain the test and obtain consent from the client before applying any equipment.
Choice B is wrong because instructing the client to press a button when she feels fetal movement is part of the nonstress test procedure, but not the first action.The nurse should first educate the client about the test and its purpose.
Choice D is wrong because activating a vibroacoustic stimulation device to wake up the fetus is not necessary for a nonstress test.This device may be used if the fetal heart rate is nonreactive, but only after explaining the test and obtaining consent from the client.
A nurse is reviewing the results of a nonstress test (NST) for a client who is at 32 weeks of gestation and has diabetes mellitus.
The nurse notes that the fetal heart rate (FHR) accelerates at least 10 beats/min for at least 10 seconds two or more times in a 30-minute period.
How should the nurse interpret this result?
Explanation
Reactive.This means that the fetal heart rate (FHR) accelerates at least 10 beats/min for at least 10 seconds two or more times in a 30-minute period.This result shows that the baby is getting enough oxygen and is doing well.
Nonreactive.
This means that the FHR does not accelerate as expected during the test.This result does not necessarily mean that there is a problem, but it may indicate that the baby is not getting enough oxygen or is asleep.
If this happens, more tests may be needed.
Unsatisfactory.This means that the test results are unclear or incomplete due to technical problems or poor quality of the recording.
If this happens, the test may need to be repeated.
Equivocal.This means that the test results are uncertain or inconclusive due to factors such as preterm gestation, fetal sleep, maternal medications, or fetal anomalies.
If this happens, more tests may be needed.
Normal ranges for FHR are between 110 and 160 beats/min at rest and between 120 and 180 beats/min during movement.
A nurse is performing a nonstress test (NST) for a client who is at 28 weeks of gestation and has intrauterine growth restriction (IUGR).
The nurse observes that the fetal heart rate (FHR) does not accelerate with fetal movement after 20 minutes of monitoring.
Which of the following tests should the nurse anticipate to be ordered next for this client? (Select all that apply.)
Explanation
Abiophysical profile (BPP)is a test that combines a nonstress test with an ultrasound to assess fetal well-being.Aumbilical artery Doppler velocimetryis a test that measures the blood flow in the umbilical cord to detect fetal growth restriction.Both of these tests are indicated for a client who has a nonreactive nonstress test (NST), which means that the fetal heart rate does not accelerate with fetal movement after 20 minutes of monitoring.
Choice B is wrong because acontraction stress test (CST)is a test that stimulates uterine contractions to evaluate how the fetal heart rate responds to stress.It is not recommended for clients who have intrauterine growth restriction (IUGR) because it can compromise fetal oxygenation.
Choice D is wrong because anamniocentesisis a test that obtains amniotic fluid for genetic testing, fetal lung maturity, or infection.It is not used to assess fetal well-being or growth.
Choice E is wrong because afetal kick countis a method of monitoring fetal movement at home by counting how many times the fetus kicks in a certain period of time.It is not a test that can be ordered by a health care provider.
A nurse is caring for a client who is at 34 weeks of gestation and has systemic lupus erythematosus (SLE).
The provider orders a nonstress test (NST) twice a week for this client.
Which of the following statements by the nurse is appropriate when educating the client about this test?
Explanation
“This test will evaluate your baby’s well-being by monitoring his or her movements.”
A nonstress test (NST) is a simple, noninvasive way of checking on your baby’s health.The test records your baby’s movement, heartbeat, and reaction to movement.It is done after 26 to 28 weeks of pregnancyto check the health and oxygen supply of the fetus.It is safe, painless, and non-invasive, and can be performed in a doctor’s office or a hospital.It usually takes 40 to 60 minutes.
Choice A is wrong because this test will not measure the amount of amniotic fluid around your baby.That is done by another test called an amniotic fluid index (AFI).
Choice B is wrong because this test will not check if your baby has any chromosomal abnormalities.That is done by other tests such as amniocentesis or chorionic villus sampling (CVS).
Choice C is wrong because this test will not assess how your baby’s heart rate responds to contractions.That is done by another test called a contraction stress test (CST).
A nurse is conducting a nipple-stimulated contraction stress test (CST) for a client who had a nonreactive nonstress test (NST).
Which of the following instructions should the nurse give to the client for this test?
Explanation
The nurse should instruct the client to brush her nipple with her palm for 2 minutes.
This will stimulate the release of oxytocin and cause uterine contractions.The fetal heart rate (FHR) will be monitored for any signs of fetal distress, such as decelerations.
Choice A is wrong because fasting is not required for a CST.Fasting may be necessary for other tests that involve anesthesia or sedation.
Choice B is wrong because drinking orange juice will not induce contractions.Orange juice may be given to increase fetal activity before a nonstress test (NST), which measures the FHR response to fetal movement.
Choice D is wrong because lying on the back can compress the inferior vena cava and reduce blood flow to the uterus and the fetus.The client should lie on her side during the test to prevent supine hypotension syndrome.
Normal ranges for FHR are 110 to 160 beats per minute, with moderate variability and no decelerations.Normal ranges for uterine contractions are less than five in a 10-minute period, lasting less than 90 seconds each.
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