30. A client, who is gravida 4, para 3, delivered a "fetal demise" last year. A physician orders a contraction stress test (CST) for this client at 38 weeks' gestation. A nurse is aware that a contraction stress test is ordered for this client to:
30. A client, who is gravida 4, para 3, delivered a "fetal demise" last year. A physician orders a contraction stress test (CST) for this client at 38 weeks' gestation. A nurse is aware that a contraction stress test is ordered for this client to:
. Determine lung maturity.
. Measure the fetal activity.
. Check the fetal oxygen reserve.
. Measure the amniotic fluid.
Test-Taking Tip
Electronic fetal monitoring can only determine fetal well-being; it cannot evaluate amniotic fluid or lung development. Eliminate those options that cannot evaluate fetal monitoring.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Diagnostic Tests
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Answer 1 is incorrect because an amniocentesis is required to check fetal lung maturity, using analysis of amniotic fluid. Fetal monitoring cannot determine lung maturity. Answer 2 is incorrect because the purpose of a CST is to check the fetal oxygen reserve. A daily fetal kick count is used to measure the fetal activity. Answer 3 is correct because the test uses a fetal monitor to watch the baby's response to contractions. A healthy fetus in good condition will tolerate the mild stress caused by contractions without difficulty. However, a fetus who is getting barely enough oxygen may have late decelerations, where the baby's heart slows down from the stress of the contraction, then recovers back to baseline after a few moments. In this way, a CST is able to check fetal oxygen reserve. Answer 4 is incorrect because an ultrasound is required to measure the amniotic fluid; fetal monitoring cannot determine amniotic fluid volume.