A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman: (Select the one most appropriate answer.

Choice A reason: Nonreactive is not the correct result, as it indicates that the FHR does not show adequate accelerations with fetal movement. A nonreactive NST means that the FHR does not increase by at least 15 beats/min for at least 15 seconds in a 20-minute period. A nonreactive NST may suggest fetal hypoxia (low oxygen) or fetal sleep.

Choice B reason: Reactive is the correct result, as it indicates that the FHR shows adequate accelerations with fetal movement. A reactive NST means that the FHR increases by at least 15 beats/min for at least 15 seconds twice or more in a 20-minute period. A reactive NST is reassuring and suggests that the fetus is well-oxygenated and healthy.

Choice C reason: Positive is not the correct result, as it is not used to describe the NST. Positive is a term used for the contraction stress test (CST), which is a different test that measures the FHR in response to uterine contractions. A positive CST means that the FHR shows late decelerations (decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends) with at least 50% of the contractions. A positive CST indicates uteroplacental insufficiency (a condition where the placenta does not deliver enough oxygen and nutrients to the fetus) and fetal distress.

Choice D reason: Negative is not the correct result, as it is also not used to describe the NST. Negative is another term used for the CST, which is a different test that measures the FHR in response to uterine contractions. A negative CST means that the FHR does not show any late decelerations during at least three contractions in a 10-minute period. A negative CST is reassuring and suggests that the fetus is well-oxygenated and can tolerate labor.

Choice A reason: Women without pain and who do not want to become pregnant need no treatment, as endometriosis is a benign condition that does not affect the general health or well-being of the woman. The nurse should explain to the client that endometriosis is a chronic condition that causes the growth of endometrial tissue outside the uterus, and that it can cause symptoms such as pelvic pain, dysmenorrhea, dyspareunia, and infertility. However, if the woman is asymptomatic and has no desire for pregnancy, she can choose to monitor the condition without any intervention.

Choice B reason: Surgical intervention often is needed for severe or acute symptoms, as endometriosis can cause complications such as adhesions, cysts, inflammation, or obstruction of the pelvic organs. The nurse should inform the client that surgery can be performed to remove or destroy the endometrial implants, or to perform a hysterectomy or oophorectomy in severe cases. The nurse should also discuss the benefits and risks of surgery, and the possibility of recurrence or persistence of symptoms.

Choice C reason: Side effects from the steroid danazol include masculinizing traits, as danazol is a synthetic androgen that suppresses the ovarian function and reduces the production of estrogen and progesterone. The nurse should warn the client that danazol can cause adverse effects such as acne, hirsutism, weight gain, voice changes, decreased breast size, and menstrual irregularities. The nurse should also advise the client to use a non-hormonal contraceptive method while taking danazol, as it can harm the fetus if pregnancy occurs.

Choice D reason: Bone loss from hypoestrogenism is not irreversible, as it can be prevented or treated with calcium and vitamin D supplements, bisphosphonates, or hormone replacement therapy. The nurse should educate the client that hypoestrogenism is a condition where the estrogen levels are abnormally low, and that it can occur as a result of some medications or surgical procedures for endometriosis. The nurse should also explain that hypoestrogenism can increase the risk of osteoporosis, which is a condition where the bones become weak and brittle.

Choice E reason: Women with mild pain who may want a future pregnancy may take nonsteroidal anti-inflammatory drugs (NSAIDs), as NSAIDs can reduce the inflammation and pain caused by endometriosis. The nurse should recommend the client to take NSAIDs as needed, and to follow the dosage and instructions on the label. The nurse should also inform the client that NSAIDs are not effective in treating the underlying cause of endometriosis, and that they may have side effects such as gastrointestinal irritation, bleeding, or ulcers.