When preparing a client for an emergency cesarean birth with no time to administer spinal anesthesia, what is the greatest risk of administering general anesthesia to the client?

The correct answer is C. The test results are normal.

Choice A rationale:

A biophysical profile (BPP) score of 8 does not necessarily indicate a need for immediate cesarean delivery.

Cesarean delivery is typically reserved for cases where there is a clear and urgent risk to the health of the mother or fetus, such as severe fetal distress or placental abruption.

A score of 8, while not the highest possible score, is still within the normal range and does not, by itself, constitute a reason for immediate surgical intervention.

Choice B rationale:

Additional tests may be considered in certain cases, such as when the BPP score is borderline or when there are other risk factors present.

However, a score of 8 is generally considered reassuring and does not typically warrant further testing.

It's essential to evaluate the BPP score in the context of the overall clinical picture, including the gestational age, maternal health, and fetal history.

Choice D rationale:

While an obstetric specialist may review the BPP results and discuss delivery options with the patient, this is not typically done within a week for a score of 8.

A score of 8 indicates reassuring fetal well-being, and there is usually no need for such urgent consultation or decision-making.

The timing of delivery discussions would depend on the overall clinical situation and the patient's individual preferences.

Choice C rationale:

A BPP score of 8 is considered normal.

It suggests that the fetus is well-oxygenated and has normal heart rate, breathing movements, muscle tone, and amniotic fluid levels.

This score does not raise immediate concerns about fetal well-being and does not typically require any immediate interventions.

Choice A rationale:

A positive contraction stress test (CST) indicates that the fetal heart rate decelerates late in response to uterine contractions, suggesting potential uteroplacental insufficiency. However, the scenario does not describe a CST being performed, as it does not mention any assessment of uterine contractions or their relationship to fetal heart rate changes.

Choice C rationale:

A negative contraction stress test (CST) would demonstrate no late decelerations in response to contractions, suggesting adequate placental function. However, as mentioned earlier, a CST is not the test being performed in this scenario.

Choice D rationale:

A non-reactive nonstress test (NST) means that there were not enough fetal heart rate accelerations (at least 2, each lasting at least 15 seconds and peaking at least 15 beats above baseline) within a 20-minute period. This finding sometimes warrants further evaluation of fetal well-being. However, the scenario clearly states that 3 accelerations meeting the criteria for reactivity were observed.

Choice B rationale:

A reactive nonstress test (NST) is considered reassuring and indicates that the fetal heart rate is responding appropriately to fetal movement, suggesting that the fetus is likely healthy and well-oxygenated. The presence of 3 accelerations meeting the criteria for reactivity within a 20-minute period is the hallmark of a reactive NST.