A nurse is performing an external nonstress test for a client who is at 41 weeks of gestation and has oligohydramnios.

The nurse notes that there are no accelerations in the fetal heart rate tracing after applying an acoustic stimulator to the maternal abdomen for several seconds.

Which of the following actions should the nurse take?

The client should count the baby’s kicks every day to monitor fetal well-being.A nonreactive nonstress test (NST) indicates that the fetal heart rate did not increase adequately with fetal movement, which may suggest fetal hypoxia or distress.A biophysical profile (BPP) is a combination of NST and ultrasound that assesses five parameters: fetal breathing, movement, tone, amniotic fluid volume, and NST.

Each parameter is scored 0 or 2, and the total score ranges from 0 to 10.A score of 8/10 or 10/10 is considered normal, while a score of 6/10 is equivocal and ≤ 4/10 is abnormal.A BPP score of 8/10 with a nonreactive NST means that the fetus has normal biophysical activities but may have chronic hypoxia.

Choice A is wrong because the client does not need to have another BPP in a week unless there are other indications of fetal compromise.The BPP may be repeated once or twice a week depending on the clinical situation.

Choice C is wrong because the client does not need to have an amniocentesis as soon as possible.

Amniocentesis is an invasive procedure that involves inserting a needle into the uterus to obtain amniotic fluid for analysis.It is usually done for prenatal diagnosis of genetic disorders or fetal lung maturity, not for fetal well-being.

Choice D is wrong because the client does not need to deliver the baby by cesarean section.Cesarean section is a surgical delivery that may be indicated for various maternal or fetal conditions, such as placenta previa, breech presentation, fetal distress, or failure to progress in labor.A BPP score of 8/10 with a nonreactive NST does not warrant a cesarean section unless there are other risk factors or complications.

NST is less time-consuming and more comfortable than CST.This is because NST does not require any external stimulation of the uterus, while CST involves giving oxytocin to induce contractions.NST also does not pose any risk of preterm labor or fetal distress, which are possible complications of CST.

Choice A is wrong because NST does not provide more information about fetal status than CST.In fact, CST can detect fetal hypoxia more accurately than NST.

Choice C is wrong because NST does not have fewer contraindications than CST.Both tests have similar contraindications, such as placenta previa, multiple gestation, and previous cesarean section.

Choice D is wrong because NST does not have higher sensitivity and specificity than CST.

Sensitivity refers to the ability of a test to correctly identify positive cases, while specificity refers to the ability of a test to correctly identify negative cases.

NST has a high sensitivity but a low specificity, meaning it can detect most fetuses with hypoxia but also has many false positives.CST has a low sensitivity but a high specificity, meaning it can miss some fetuses with hypoxia but also has few false negatives.