A client who is 32 weeks gestation and has gestational diabetes calls the provider’s office to report decreased fetal movement over the last several hours. The provider advises her to report to OB triage for further testing.
What test should you anticipate the provider will order?
Non-stress test.
Contraction stress test.
Biophysical profile.
Ultrasound.
The Correct Answer is A
Choice A rationale
A non-stress test (NST) is a common test used to evaluate fetal well-being, especially in cases of decreased fetal movement. It measures the fetal heart rate in response to its movements. A reactive NST, where the fetal heart rate increases with movement, indicates good oxygenation and neurological function.
Choice B rationale
A contraction stress test (CST) evaluates the fetal heart rate response to uterine contractions, which can be induced by oxytocin or nipple stimulation. It is typically used to assess placental function and fetal tolerance to labor, not for initial assessment of decreased fetal movement.
Choice C rationale
A biophysical profile (BPP) combines an NST with ultrasound to assess fetal breathing, movement, tone, and amniotic fluid volume. While comprehensive, it is more time-consuming and usually reserved for further evaluation if the NST is non-reactive.
Choice D rationale
An ultrasound can assess fetal growth, amniotic fluid volume, and anatomical structures. However, it does not provide real-time information on fetal heart rate reactivity, making it less suitable for immediate assessment of decreased fetal movement.
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View Related questions
Correct Answer is A
Explanation
Choice A rationale
This statement is incorrect because Stage 2 of labor does not involve the delivery of the placenta. Stage 2 starts with the complete dilation and effacement of the cervix and ends with the delivery of the fetus. The delivery of the placenta occurs in Stage 3 of labor.
Choice B rationale
This statement is correct. Stage 2 of labor begins with complete effacement and dilation of the cervix. This stage is characterized by the mother pushing and the eventual delivery of the baby.
Choice C rationale
This statement is also correct. Stage 2 starts when the cervix is fully dilated, allowing the mother to start pushing. This stage continues until the baby is born.
Choice D rationale
This statement is incorrect. Stage 2 ends with the delivery of the fetus, not the placenta. The delivery of the placenta is part of Stage 3 of labor.
Correct Answer is A
Explanation
Choice A rationale
Terbutaline is a beta-adrenergic agonist that works by relaxing the smooth muscles of the uterus, thereby reducing uterine contractions. It is commonly used in cases of tachysystole and recurrent late decelerations to decrease uterine activity and improve fetal oxygenation. Terbutaline’s mechanism of action involves stimulating beta-2 adrenergic receptors, which leads to an increase in cyclic AMP and subsequent relaxation of uterine smooth muscle.
Choice B rationale
Oxytocin is a hormone that stimulates uterine contractions and is typically used to induce or augment labor. Administering oxytocin in a situation where there is already tachysystole and recurrent late decelerations would exacerbate the problem by increasing uterine contractions, potentially leading to further fetal distress.
Choice C rationale
Misoprostol is a prostaglandin analog used to ripen the cervix and induce labor. Similar to oxytocin, it would not be appropriate in this scenario as it would increase uterine contractions, worsening the tachysystole and late decelerations.
Choice D rationale
Magnesium sulfate is primarily used as a tocolytic to prevent preterm labor and as a neuroprotective agent for the fetus in cases of preeclampsia. While it has some uterine relaxation properties, it is not the first-line treatment for reducing uterine activity in the context of tachysystole and late decelerations.