A nurse is educating a 38-week pregnant client about the ordered contraction stress test. Which of the following is correct regarding the contraction stress test?
We administer oxytocin through the IV to identify whether you can tolerate the pain of labor.
Positive contraction stress tests are associated with good fetal outcomes.
A negative result is a good indicator of fetal well-being.
We are looking for a positive test which has been associated with an increased rate of fetal death, fetal growth restriction, lower Apgar scores, need for C-section, and need for neonatal resuscitation.
The Correct Answer is C
Choice A rationale
Administering oxytocin during a contraction stress test is to assess uteroplacental insufficiency, not to identify pain tolerance. The test evaluates fetal response to contractions.
Choice B rationale
Positive contraction stress tests are associated with poor fetal outcomes, indicating fetal distress during contractions due to inadequate placental perfusion.
Choice C rationale
A negative result in a contraction stress test indicates adequate placental function and fetal well-being, suggesting the fetus can tolerate labor without distress.
Choice D rationale
A positive test result suggests potential fetal compromise, including increased risk of fetal death, growth restriction, low Apgar scores, and need for C-section or resuscitation.
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Correct Answer is C
Explanation
Choice A rationale
Fetal movement below normal may indicate compromised oxygenation or fetal distress. Reporting such observations is crucial for further assessment and timely intervention.
Choice B rationale
Consuming food and resting can increase glucose levels, potentially enhancing fetal movement. Monitoring for 1 hour helps to evaluate if decreased movement persists, indicating the need for further assessment.
Choice C rationale
Pregnant women should not lay prone for kick counts. This position can compress major blood vessels, reducing blood flow and oxygenation to the fetus. The left lateral position is preferred.
Choice D rationale
Reduced fetal movement can indicate decreased oxygenation in compromised fetuses. Monitoring fetal activity helps assess fetal well-being and identify potential hypoxia or distress.
Correct Answer is B
Explanation
Choice A rationale
Cord compression typically causes variable decelerations on the monitor, which are abrupt decreases in fetal heart rate, often with a U, V, or W shape.
Choice B rationale
Head compression leads to early decelerations, which are gradual decreases in fetal heart rate occurring with contractions. This pattern indicates head compression during labor.
Choice C rationale
Placental insufficiency results in late decelerations, where the fetal heart rate decreases after the peak of a contraction. This pattern suggests compromised placental blood flow.
Choice D rationale
Reactive NST (Non-Stress Test) indicates fetal well-being and is characterized by fetal heart rate accelerations, not decelerations.
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