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.)

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.

“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).