Maternal-OB Test 3
Fetal Kick counts
"10 and 2"; start at 28 weeks Tips: lay down after drinking something sweet Fetal alarm= no kicks for 12 hours --> come in to find FHR
B, C, E
A nurse is reviewing findings of a clients biophysical profile. The nurse should expect which of the following variables to be included in the (select all that apply)? A. Fetal weight B. Fetal breathing movement C. Fetal tone D. Fetal position E. Amniotic fluid volume
A nurse is caring for a client who is pregnant and is to undergo a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply) A. Decreased Fetal movement B. Intrauterine Growth Restriction (IUGR) C. Postmaturity D. Placenta Previa E. Amniotic fluid emboli
A, B, C decreased fetal movement, IUGR, and postmaturity are indications for a CST
What tests are included in the quad screening?
AFP, Unconjugated Estriol, Human chorionic gonadotropin, Dimeric Inhibin A
AFI
Amniotic fluid index >2000mls=poly/hydra <500mls=oligo 5-19=normal
When is the quad screening performed?
Between 15-21.6 weeks
A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements should the nurse include in the teaching? A. You will lay on your right side during the procedure." B. "You should not eat anything for 24 hours prior to the procedure." C. "You should empty your bladder prior to the procedure." D. "The test is done to determine gestational age."
C. "You should empty your bladder prior to the procedure." The client's bladder should be empty to avoid inadvertent puncture during the procedure.
A nurse is caring for a client who is pregnant and undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. Which of the following responses should the nurse make? A. "It is used to stimulate uterine contractions." B. "It will decrease the incidence of uterine contractions." C. "It lulls the fetus to sleep." D. "It awakens a sleeping fetus."
D. "It awakens a sleeping fetus." The acoustic vibration device is activated for 3 seconds on the maternal abdomen over the fetal head to awaken a sleeping fetus
Possibilities for Meconium (in before birth)
Drugs, post maturity(greater than 42 weeks), compression causing vagal stimulation(cranial nerve 10; often d/t drugs), hypoxia( d/t nuchal cord, placental problems, etc)
Nonstress test tips
Empty bladder, offer orange juice or use VAS
Nonstress test results
Increase by 15 bpm x 15 seconds x 2 times x within 20 minutes Meet criteria within 40 minutes or considered non-reactive So if nonreactive in 20 minutes-extend test for a total of 40 minutes; if not reactive after 40 minutes = nonreactive
What is precutaneous umbilical blood sampling?
Often called cordocentesis Most common method for fetal blood sampling and transfusion Takes blood from the vein; guided by ultrasound
What does the quad screening test for?
Trisomy 18, Trisomy 21, Neural tube defects
Contraction Stress Test
Assesses if baby is capable of enduring labor contractions Negative=Good Positive=Bad--> late decelerations Use terbutaline to stop contractions
Nonstress Test
Assesses fetus for an intact CNS and rules out fetal death in clients who have diabetes Mellitus; used twice a week starting at 28 to 32 weeks of gestation
A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. The nurse should evaluate which of the following tests to assess fetal lung maturity?
B. Lecithin/sphingomyelin (L/S) ratio A test of the L/S ratio is done as a part of an amniocentesis to determine fetal lung maturity.
A nurse is caring for a client who is at 42 weeks of gestation and in active labor. Which of the following findings is the fetus at risk for developing? A. Intrauterine growth restriction B. Hyperglycemia C. Meconium aspiration D. Polyhydramnios
C. Meconium aspiration Postterm neonates are at risk for aspiration of meconium
Biophysical Profile (BPP)
Fetal breathing movements, FHR, Fetal Tone, Movements, AFI 2 pts for each category for a maximum score of 10 Norm= 8-10 Abnorm= <4 (should prepare for delivery)
Amniocentesis, PUBS, and CVS can cause what?
Shearing of the placenta, infection, rupture of membranes