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  1. What is the 3rd trimester goal?
    to determine whether the intrauterine environment continues to be supportive to the fetus.
  2. What is a NST?
    Nonstress Test

    Performed easily & quickly in an outpatient setting.

    Test is usually completed within 20-30 minutes, but may be required if fetus needs to be awakened
  3. What is the most common cause for a nonreactive test?
    common absence of FHR accelerations is the quiet fetal sleep state.
  4. What can the nurse do to stimulate fetal movements?
    suggest that a woman drinks OJ to increase her blood sugar level
  5. What test is performed after a nonreactive NST?
    The test is often extended an additional 20 minutes, and if it does not meet the criteria after 40 min a CST & BPP is usually performed
  6. What is a reacitive result of a NST?
    Two accelerations in a 20 min period each lasting 15 sec and peaking at least 15 breat/min above baseline
  7. what is a nonreactive test for NST show?
    a test that does not produce 2 or more qualifying accelerations in a 20 min period
  8. What does vibroacoustic stimulation do?
    often used to stimulate fetal activity if the initial NST results are nonreactive
  9. How long does a vibroacoustic stimulation test take to complete?
    takes approx 15 min to complete with fetus monitor for 5-10 before stilulation to obtain baseline FHR.

    If baseline pattern is non-reactive the sound source is then activated for 3 sex on maternal abdomen over fetal head.

    Monitoring contiues for 5 min
  10. Can a vibroacoustic test be repeated?
    Yes @ 1 min intervals up to 3x when there is no responce.
  11. If results is non reactive in vibro and NST what else do you do?
    BPP and CST
  12. What is a CST?
    Contraction Stress Test
    Identifies the jeoparidized fetus who is stable @ rest but shows evidence when exposed to stress of UC.
  13. What is the cons of CST?
    • 1. More time consuming
    • 2. More expensive
  14. In CST, what does late decels show?
  15. What is the procedure of a CST?
    • 1. semi-fowler position
    • 2. monitored electronically by fetal ultrasound & toco
    • 3. Observered for 10-20 min for baseline, variability & occure of contractions
  16. What are the 2 types of CST?
    • 1. Nipple Stimulation Contraction Test
    • 2. Oxytocin Stimulation contraction test
  17. How do you do the Nipple stimulation contraction test?
    • 1. apply warm H2O w/washcloth to both breasts for several min
    • 2. massage 1 nipple for 10 min through clothes for 2 min
    • 2. Rest for 5 min, repeat cycles & rest as necessary to achieve uterine activity
  18. What is an adequate contraction for CST nipple stimulation test?
    UC lasting more than 90 sec ir 5 or moe contractions in 10 min
  19. What is an oxytocin stimulated contraction test?
    IV of oxytocin to stimulate UC.
  20. How is the oxytocin hung in the CST?
    piggyback & delivered by pump
  21. What rate do you hang the oxytocin for CST?
    begin at 0.5 milliunits/min double the dose every 20 min until 3 UC of good quality lasting 40-60 sec observed within 10 min period.
  22. When performing a CST, using a oxytocin stimulator, what dose is usually enough to get adeqaute UC?
  23. When performing a CST, what is a major SE that you need to monitor?
  24. When you have results of CST, what does a negative indicate?
    no late decels observed, repeat in 1 week
  25. When you have results of a CST, what does POSITIVE indicate and what are its associations??
    repetive decels

    • 1. Intrauterine fetal death
    • 2. late fetal decels in labor
    • 3. IUGR
    • 4. meconium stained amniotic fluid
  26. When would you hospitalize a patient for CST & why?
    Positive results to watch for close observation, or delivery or both
  27. When performing a CST, what do you WANT?
    3 contractions lasting 60-90 sec in 10 min
  28. True or False:
    When performing a CST, increase in FHR is good.
  29. When performing a CST, and you have a decrease in FHR then rebound what type of heart rate is that?
    Early decelerations: okay
  30. When performing a CST, and you have a late decelerations what does that indicate and what do you do?
    hypoxia and you stop delivering oxytocin
  31. When women are dx with a high risk pregnancy, her & her family will likely experience what?
    stress r/t dx
  32. When dx with a high risk pregancy women experience many emotions, what are some normal psychological responses?
    • anxiety
    • low self esteem/guilt
    • frusteration
    • inability to function
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