A nurse is reviewing the contraindications for a Contraction Stress Test (CST) with a pregnant client.
Which condition would be a contraindication for the test?
Gestational diabetes.
Mild preeclampsia.
Preterm labor.
Ruptured membranes.
The Correct Answer is D
This is a contraindication for the Contraction Stress Test (CST) because it increases the risk of infection and umbilical cord prolapse.
A CST is a test that measures the baby’s heart rate during uterine contractions induced by oxytocin or nipple stimulation.
Choice A is wrong because gestational diabetes is not a contraindication for the CST.
It is a condition that affects how the body processes glucose during pregnancy and may cause complications such as macrosomia (large baby), hypoglycemia (low blood sugar) or preeclampsia (high blood pressure and protein in urine).
Choice B is wrong because mild preeclampsia is not a contraindication for the CST.
It is a condition that causes high blood pressure and protein in urine after 20 weeks of pregnancy and may affect the placenta, kidneys, liver or brain.
Choice C is wrong because preterm labor is a relative contraindication for the CST, not an absolute one.
It means that the test may be performed if the benefits outweigh the risks, but it should be avoided if possible because it may trigger early labor or delivery.
Preterm labor is defined as regular uterine contractions with cervical changes before 37 weeks of pregnancy.
Normal ranges for blood pressure are below 120/80 mmHg, for glucose are 70-100 mg/dL (fasting) or below 140 mg/dL (2 hours after eating), and for protein in urine are less than 300 mg/24 hours.
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Related Questions
Correct Answer is C
Explanation
This means that the baby’s heart rate did not slow down after the contractions induced by oxytocin, which is a sign of normal fetal well-being.
A negative CST is normal and desirable.
Choice A is wrong because no contractions were induced during the test.
This means that the test was inconclusive and could not assess the baby’s response to stress.
Choice B is wrong because late decelerations of the FHR were observed with at least 50% of contractions.
This means that the baby’s heart rate slowed down and stayed slow after the contractions, which is a sign of fetal distress and hypoxia.
A positive CST is abnormal and concerning.
Choice D is wrong because the client experienced mild uterine cramping during the test.
This is not a relevant factor for interpreting the CST results, which depend on the FHR patterns.
Uterine cramping can be a side effect of oxytocin administration or nipple stimulation.
Correct Answer is B
Explanation
The correct answer is choice B. Monitor fetal heart rate.
This is because cramping and vaginal bleeding after amniocentesis are signs of possible complications such as miscarriage, preterm labor, or injury to the fetus.
Monitoring fetal heart rate can help assess the well-being of the fetus and detect any signs of distress.
Choice A is wrong because administering Rho(D) immunoglobulin is only necessary if the mother has Rh-negative blood and the baby has Rh-positive blood, which can cause Rh sensitization.
This is not given routinely to all women who have amniocentesis.
Choice C is wrong because assessing maternal vital signs is not the first priority when there is a risk of fetal compromise.
Maternal vital signs can be affected by many factors and are not specific indicators of fetal health.
Choice D is wrong because obtaining an order for an ultrasound exam is not the first action to take.
An ultrasound exam can help confirm the diagnosis of complications such as placental abruption or fetal demise, but it requires time and equipment that might delay immediate intervention.
Monitoring fetal heart rate can be done quickly and easily at the bedside.
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