A nurse caring for a client during a non-stress test (NST) notes fetal movement. Each deceleration lasts 30 seconds.
Which of the following results are in?

Negative test.

Positive test.

Reactive test.

Non-reactive deceleration of rising in the fetal heart rate during a period.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

A negative test implies a non-reactive NST, meaning the fetal heart rate (FHR) did not demonstrate the expected accelerations in response to fetal movements.

However, the scenario states that fetal movements were noted, and decelerations were observed. Decelerations, even lasting 30 seconds, are not consistent with a negative test.

Choice B rationale:

A positive test is not a standard term used in the context of NST results.

The term "positive" is more often associated with tests that identify a specific condition or abnormality.

NST results are typically classified as reactive or non-reactive, with further interpretation based on the presence or absence of decelerations and other FHR patterns.

Choice C rationale:

A reactive NST is the desired outcome, indicating a healthy fetal response to movement.

It requires two or more FHR accelerations of at least 15 beats per minute for a minimum of 15 seconds, each within a 20- minute period.

Although the decelerations lasting 30 seconds warrant further assessment, they do not negate the presence of the required accelerations, making the test reactive.

Choice D rationale:

"Non-reactive deceleration of rising in the fetal heart rate during a period" is not a standard NST result terminology.

It incorrectly combines elements of non-reactivity (lack of accelerations) with a description of decelerations, which are distinct FHR patterns.

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Correct Answer is C

Explanation

Choice A, 42022:
This option incorrectly counts the elective abortion as a term birth. Elective abortions, regardless of gestational age, are not considered term births in the GTPAL system. They are classified under abortions (A).

Including the elective abortion as a term birth would overestimate the client's parity, leading to inaccurate assessment of her reproductive history.

Choice B, 20022:
This option incorrectly excludes the elective abortion from the GTPAL calculation. Elective abortions are considered pregnancies and are included in the gravida (G) count.
Omitting the elective abortion would underestimate the client's overall pregnancy history and potentially overlook relevant factors related to her reproductive health.

Choice D, 20222:
This option incorrectly counts the spontaneous abortion as a preterm birth. Spontaneous abortions that occur before 20 weeks of gestation are not classified as preterm births in the GTPAL system. They are categorized as abortions (A).
Classifying the spontaneous abortion as a preterm birth would misrepresent the client's obstetric history and potentially lead to inappropriate care decisions.

Choice C, 40122:
This option accurately reflects the client's parity based on the GTPAL system:
Gravida (G): 4 (total pregnancies, including elective abortion, spontaneous abortion, twin birth, and current pregnancy) Term (T): 0 (no previous term births)
Preterm (P): 1 (twin birth at 36 weeks, considered preterm as it occurred before 37 weeks) Abortions (A): 2 (elective abortion and spontaneous abortion)
Living children (L): 2 (twins from the previous pregnancy)

A. Perform daily fetal movement counts. B. Limit fluid intake to 1,000 ml/day. C. Limit sodium intake to 2,000 mg/day. D. Rest in bed in the supine position.

Correct Answer is A

Explanation

Choice A rationale:
Fetal movement counts are a simple yet effective tool to monitor fetal well-being in women with preeclampsia. They provide valuable insights into the baby's activity level and can alert the healthcare team to potential concerns early on.
Preeclampsia can compromise placental blood flow, which can lead to decreased fetal movement. By tracking fetal movements daily, the mother can detect any significant changes or reductions in activity, prompting further assessment and intervention if necessary.
Research has shown that regular fetal movement counts can reduce the risk of stillbirth in women with preeclampsia. This is because prompt recognition of decreased fetal movements allows for timely interventions, such as closer monitoring, induction of labor, or delivery, to prevent adverse outcomes.
Daily fetal movement counts empower women to take an active role in their pregnancy care and contribute to a sense of control in a condition that can often feel unpredictable. This increased involvement can promote maternal-fetal bonding and reduce anxiety.
Choice B rationale:
While fluid restriction has been a traditional recommendation for preeclampsia, current evidence does not support limiting fluid intake to 1,000 ml/day. In fact, excessive fluid restriction can lead to dehydration, which can worsen placental perfusion and compromise fetal well-being.
It's essential for women with preeclampsia to maintain adequate hydration to support essential bodily functions and fetal growth. Adequate fluid intake also helps to prevent urinary tract infections, which are more common in women with preeclampsia.
Choice C rationale:
Although reducing sodium intake can be beneficial for overall blood pressure control, there's insufficient evidence to support a strict sodium restriction of 2,000 mg/day specifically for managing mild preeclampsia. Individual needs may vary, and a more moderate approach to sodium reduction is often recommended.
Focusing on a balanced, healthy diet with appropriate sodium intake is generally more effective than strict limitations. This approach promotes overall well-being and supports healthy blood pressure levels without compromising nutritional needs. Choice D rationale:
Rest is often recommended for women with preeclampsia to reduce stress on the cardiovascular system and promote placental blood flow. However, the supine position (lying on the back) is not ideal, as it can further compress the large blood vessels in the abdomen and potentially reduce blood flow to the placenta.
Side-lying positions, particularly the left lateral position, are preferred for women with preeclampsia. These positions help to alleviate pressure on the major blood vessels, enhance blood flow, and improve uteroplacental circulation, which benefits both the mother and the baby.

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A nurse caring for a client during a non-stress test (NST) notes fetal movement. Each deceleration lasts 30 seconds. Which of the following results are in?

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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A nurse caring for a client during a non-stress test (NST) notes fetal movement. Each deceleration lasts 30 seconds.
Which of the following results are in?