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A nurse is performing an external nonstress test for a client who is at 41 weeks of gestation and has oligohydramnios.

The nurse notes that there are no accelerations in the fetal heart rate tracing after applying an acoustic stimulator to the maternal abdomen for several seconds.

Which of the following actions should the nurse take?



Correct Answer: D

Notify the provider and prepare for delivery. Oligohydramnios is a condition where the amniotic fluid volume is less than expected for gestational age and it is associated with maternal and fetal complications.

The nonstress test (NST) is a method of fetal surveillance that measures the fetal heart rate response to fetal movement. A reactive NST is defined as at least two accelerations of 15 beats per minute or more above the baseline, lasting 15 seconds or more, within a 20-minute period.

A nonreactive NST indicates fetal hypoxia or acidosis and requires further evaluation. An acoustic stimulator can be used to elicit fetal movement and accelerations, but it should not be repeated more than once in a 10-minute period.

Therefore, choice A is wrong because repeating the acoustic stimulation after 1 minute is too soon and may cause fetal distress.

Choice B is wrong because documenting the finding as a nonreactive NST is not enough to address the situation. Choice C is wrong because performing a contraction stress test (CST) is contraindicated in oligohydramnios because it may cause umbilical cord compression and fetal compromise.

The CST involves inducing uterine contractions with oxytocin or nipple stimulation and monitoring the fetal heart rate for signs of intolerance.

A negative CST means that there




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