A nurse is caring for a newborn with hyperbilirubinemia and is being treated with phototherapy.

For each of the following nursing actions, specify if it is indicated or contraindicated with phototherapy treatment.

Choice A rationale

Recurrent variable decelerations can indicate umbilical cord compression. Notifying the provider ensures immediate intervention if necessary to address potential fetal distress and to monitor labor progression.

Choice B rationale

Ambulation is not recommended with recurrent variable decelerations. It might increase the risk of cord prolapse or other complications, further compromising fetal wellbeing.

Choice C rationale

Repositioning to the left lateral position helps improve uteroplacental blood flow and reduce cord compression, addressing the decelerations and promoting fetal oxygenation.

Choice D rationale

Performing a sterile vaginal exam can help identify any immediate issues like cord prolapse or rapid cervical changes that could impact labor management and fetal wellbeing.

Choice E rationale

Providing an IV fluid bolus can improve maternal hydration and placental perfusion, potentially alleviating the cause of variable decelerations by increasing blood flow and reducing cord compression effects. .

Based on the provided information, here is the completion of the sentence using the options:

The nurse assesses the Non-Stress Test (NST) and documents the results as Non-Reactive. The nurse contacts the provider and reports the NST results. The nurse anticipates an order for a Biophysical Profile.

A Non-Stress Test (NST) is used to monitor the fetal heart rate (FHR) and its response to fetal movements. A reactive NST indicates that there are accelerations in the FHR in response to fetal movements, which is a sign of fetal well-being. A non-reactive NST means that there are no accelerations in the FHR with fetal movements, suggesting that the fetus might not be as active or responding as expected.

In this case, the NST was non-reactive because there were no accelerations in the fetal heart rate. This can be a cause for concern, as it may indicate potential issues with the fetus that need further evaluation. Therefore, the nurse would document the NST as non-reactive and contact the provider for further assessment.

A Biophysical Profile (BPP) is often ordered after a non-reactive NST. The BPP is a more comprehensive test that includes an ultrasound to assess fetal movement, muscle tone, breathing movements, and amniotic fluid volume, in addition to another NST. This helps to provide a clearer picture of the fetus's well-being.