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?

Negative CST.A negative CST means that there are no late or significant variable decelerations of the fetal heart rate (FHR) during three uterine contractions in 10 minutes.

This indicates that the fetus is well oxygenated and can tolerate the stress of labor contractions.

Choice A is wrong because a positive CST means that there are late decelerations of the FHR with 50% or more of the contractions.

This suggests that the fetus is at risk of hypoxia and may need early delivery.

Choice C is wrong because an unsatisfactory CST means that there are fewer than three contractions in 10 minutes or the tracing is not interpretable.

This does not provide enough information to assess the fetal well-being.

Choice D is wrong because an equivocal CST means that there are either intermittent late decelerations or significant variable decelerations.

This indicates that the fetus may have some degree of compromise and may need further testing.

Normal ranges for FHR are 110 to 160 beats per minute, and for uterine contractions are 2 to 5 per 10 minutes.

The client should count the baby’s kicks every day to monitor fetal well-being.A nonreactive nonstress test (NST) indicates that the fetal heart rate did not increase adequately with fetal movement, which may suggest fetal hypoxia or distress.A biophysical profile (BPP) is a combination of NST and ultrasound that assesses five parameters: fetal breathing, movement, tone, amniotic fluid volume, and NST.

Each parameter is scored 0 or 2, and the total score ranges from 0 to 10.A score of 8/10 or 10/10 is considered normal, while a score of 6/10 is equivocal and ≤ 4/10 is abnormal.A BPP score of 8/10 with a nonreactive NST means that the fetus has normal biophysical activities but may have chronic hypoxia.

Choice A is wrong because the client does not need to have another BPP in a week unless there are other indications of fetal compromise.The BPP may be repeated once or twice a week depending on the clinical situation.

Choice C is wrong because the client does not need to have an amniocentesis as soon as possible.

Amniocentesis is an invasive procedure that involves inserting a needle into the uterus to obtain amniotic fluid for analysis.It is usually done for prenatal diagnosis of genetic disorders or fetal lung maturity, not for fetal well-being.

Choice D is wrong because the client does not need to deliver the baby by cesarean section.Cesarean section is a surgical delivery that may be indicated for various maternal or fetal conditions, such as placenta previa, breech presentation, fetal distress, or failure to progress in labor.A BPP score of 8/10 with a nonreactive NST does not warrant a cesarean section unless there are other risk factors or complications.