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.)
Biophysical profile (BPP)
Contraction stress test (CST)
Umbilical artery Doppler velocimetry
Amniocentesis
Fetal kick count
Correct Answer : A,C
A biophysical profile (BPP) is a test that combines a nonstress test with an ultrasound to assess fetal well-being. A umbilical artery Doppler velocimetry is 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 a contraction 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 an amniocentesis is 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 a fetal kick count is 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.
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Related Questions
Correct Answer is A
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.
Correct Answer is D
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).
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