A nurse is preparing a client for a fetal non-stress test (NST).

Which of the following instructions should the nurse give to the client?

Perform a biophysical profile (BPP).A BPP is a test that combines a non-stress test (NST) with an ultrasound to evaluate the fetal well-being.A BPP is indicated when an NST is non-reactive, meaning that there are no accelerations of the fetal heart rate (FHR) with fetal movements.A BPP measures five parameters: fetal movement, fetal tone, fetal breathing, amniotic fluid volume and FHR reactivity.

A BPP can help detect fetal hypoxemia or distress and guide further management.

Choice A is wrong because repeating the NST after 24 hours may delay the diagnosis and treatment of fetal compromise.A non-reactive NST requires further evaluation with a BPP or a contraction stress test (CST).

Choice B is wrong because performing a CST may not be safe for a fetus with a non-reactive NST.

A CST involves inducing uterine contractions with oxytocin or nipple stimulation and monitoring the FHR response.A CST can cause fetal distress or placental abruption if the fetus is already hypoxic.

Choice D is wrong because applying an acoustic vibration device to the abdomen may not elicit FHR accelerations if the fetus is hypoxic or asleep.An acoustic stimulation test (AST) is sometimes used to augment an NST, but it is not a substitute for a BPP.

Choice E is wrong because administering oxygen via face mask to the client may not improve the FHR reactivity if the cause of fetal compromise is not maternal hypoxia.Oxygen administration may also have adverse effects on maternal and fetal hemodynamics.

“You will need to press a button when you feel the baby move.” This is because a non-stress test (NST) is a pregnancy screening that measures fetal heart rate and reaction to movement.The test is performed to make sure the fetus is healthy and getting enough oxygen.By pressing a button when the baby moves, the patient can help the provider record the changes in the fetal heart rate.

Choice A is wrong because the patient does not need to fast for 8 hours before the test.There is no dietary restriction for an NST.

Choice B is wrong because the patient does not need to drink plenty of fluids before the test.However, drinking some fluids may help stimulate fetal movement.

Choice C is wrong because the patient does not need to lie on their back during the test.In fact, lying on the back can compress the blood vessels and reduce blood flow to the fetus.The patient can lie on their side or recline on a chair or exam table.