A nurse is performing a non-stress test (NST) for a client who is 34 weeks pregnant and has pre-eclampsia.
Which of the following fetal heart rate patterns indicates a reactive test?
Two or more accelerations of at least 15 beats/min above baseline lasting for at least 15 seconds in a 20-minute period
No accelerations or decelerations in a 20-minute period
One acceleration of at least 10 beats/min above baseline lasting for at least 10 seconds in a 20-minute period
Variable decelerations with normal variability in a 20-minute period
The Correct Answer is A
Two or more accelerations of at least 15 beats/min above baseline lasting for at least 15 seconds in a 20-minute period. This indicates a reactive test, which means that the fetus is well oxygenated and not in distress.
Choice B is wrong because no accelerations or decelerations in a 20-minute period indicate a non-reactive test, which may suggest fetal hypoxia or acidosis.
Choice C is wrong because one acceleration of at least 10 beats/min above baseline lasting for at least 10 seconds in a 20-minute period is the criterion for a reactive test for gestational age less than 32 weeks, not 34 weeks.
Choice D is wrong because variable decelerations with normal variability in a 20-minute period indicate cord compression or fetal head compression, not a reactive test.
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Related Questions
Correct Answer is C
Explanation
To accelerate fetal lung maturity.Corticosteroids are given to pregnant women with severe pre-eclampsia who are at risk of preterm delivery to help the development of the fetus’s lungs and reduce the risk of respiratory distress syndrome.
This can improve the survival and health outcomes of the newborn.
Choice A is wrong because corticosteroids do not reduce inflammation in pre-eclampsia.They are used for other inflammatory conditions such as asthma or arthritis.
Choice B is wrong because corticosteroids do not prevent infection in pre-eclampsia.They can actually increase the risk of infection by suppressing the immune system.
Choice D is wrong because corticosteroids do not increase platelet count in pre-eclampsia.They can actually decrease the platelet count by causing thrombocytopenia.
Correct Answer is A
Explanation
This indicates that the client has respiratory depression, which is a sign of magnesium toxicity.Magnesium sulfate is given to prevent and treat seizures in clients with eclampsia, but it can also cause adverse effects such as hypotension, decreased urine output, absent or diminished reflexes, and cardiac arrest.
Choice B is wrong because urine output of 50 mL/hr is within the normal range and does not indicate magnesium toxicity.The nurse should monitor the client’s urine output closely and report any decrease below 30 mL/hr.
Choice C is wrong because serum magnesium level of 6 mg/dL is within the therapeutic range of 4 to 7 mg/dL for clients receiving magnesium sulfate.The nurse should monitor the client’s serum magnesium level regularly and report any increase above 8 mg/dL, which indicates toxicity.
Choice D is wrong because patellar reflex of 2+ is normal and does not indicate magnesium toxicity.The nurse should assess the client’s deep tendon reflexes frequently and report any decrease or absence of reflexes, which indicates toxicity.
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