A nurse is caring for a client at 38 weeks gestation who arrived to the triage with complaints of decreased fetal movement. The nurse contacts the provider and reports the findings. The nurse anticipates an order for which of the following?
Non-stress test.
Biophysical profile.
Ultrasound.
Amniocentesis.
The Correct Answer is A
Choice A rationale
A non-stress test (NST) is a common initial assessment for decreased fetal movement. It evaluates fetal heart rate patterns in response to fetal movements, providing information about fetal well-being and oxygenation.
Choice B rationale
A biophysical profile (BPP) is a more comprehensive assessment that includes an NST and ultrasound evaluation of fetal movements, tone, breathing, and amniotic fluid volume. It may be ordered if the NST results are non-reassuring or if there are other concerns.
Choice C rationale
An ultrasound can provide valuable information about fetal growth, amniotic fluid volume, and placental function. It may be used in conjunction with other tests but is not the first-line assessment for decreased fetal movement.
Choice D rationale
Amniocentesis is an invasive procedure used for specific indications, such as genetic testing or assessing fetal lung maturity. It is not typically used for initial assessment of decreased fetal movement.
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Correct Answer is B
Explanation
Choice A rationale
Magnetic Resonance Imaging (MRI) is a non-invasive imaging technique that provides detailed images of the fetus and placenta. However, it is not typically used as the first-line test for assessing placental perfusion and IUGR. Doppler flow studies are more specific for evaluating blood flow and detecting issues related to placental insufficiency.
Choice B rationale
Doppler flow studies are non-invasive tests that assess blood flow in the umbilical artery and other fetal vessels. These studies are particularly useful in evaluating placental perfusion and identifying intrauterine growth restriction (IUGR). Abnormal Doppler flow patterns can indicate compromised blood flow to the fetus, which is a concern in cases of minimal fetal growth.
Choice C rationale
Amniocentesis is an invasive procedure that involves extracting a sample of amniotic fluid for genetic testing and assessment of fetal lung maturity. It is not used for evaluating placental perfusion or IUGR7.
Choice D rationale
Chorionic villus sampling (CVS) is an invasive procedure used for early genetic testing by sampling placental tissue. It is not used for assessing placental perfusion or IUGR7.
Correct Answer is A
Explanation
Choice A rationale
Monitoring the fetal heart rate is the next appropriate action. The fetal heart rate provides crucial information about the fetus’s well-being and can help identify any potential issues that may need further intervention.
Choice B rationale
Monitoring uterine contractions is important, but in this scenario, the client’s vital signs are stable, and there is no indication of labor. Therefore, monitoring the fetal heart rate takes precedence.
Choice C rationale
Amniotic fluid levels are important to monitor, but they are typically assessed through ultrasound rather than immediate bedside monitoring. The fetal heart rate provides more immediate information about the fetus’s condition.
Choice D rationale
Cervical dilation is relevant during labor, but there is no indication that the client is in labor based on the provided vital signs. Monitoring the fetal heart rate is more pertinent in this situation.