(Select all that apply) A nurse is performing a nonstress test (NST) for a client who is at 32 weeks of gestation and has gestational diabetes mellitus.

The nurse uses vibroacoustic stimulation to elicit fetal movement and acceleration of FHR.

What are the indications for using this method?

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.

The test result is nonreactive after 40 minutes.Vibroacoustic stimulation (VAS) is the application of a vibratory sound stimulus to the abdomen of a pregnant woman to induce fetal heart rate (FHR) accelerations.VAS is typically used during a nonstress test (NST) to elicit fetal movement and reactivity when the baseline FHR variability is minimal or the test result is nonreactive after 40 minutes.VAS can shorten the testing time and reduce the incidence of non-reactive cardiotocography.

Choice A is wrong because the fetus’s presentation does not affect the use of VAS.

Choice B is wrong because VAS is not indicated for a fetus that has not moved for 40 minutes, unless the NST result is also nonreactive.

Choice C is wrong because minimal baseline FHR variability is not a sufficient indication for VAS, unless the NST result is also nonreactive.

Choice D is wrong because a history of stillbirth does not affect the use of VAS.