A contraction stress test is scheduled for the pregnant client and the client asks the nurse about the test. The nurse tells the client that?

Appeared in: SJH Nursing Officer - 2019

Explanation

A Contraction Stress Test (CST) is an antepartum test that evaluates fetal well-being by observing the fetal heart rate (FHR) response to uterine contractions.
It is designed to simulate the stress of labor to identify potential uteroplacental insufficiency.
The procedure involves inducing uterine contractions to a frequency of at least three in 10 minutes.
This stimulation is correctly achieved either by administering a dilute intravenous solution of oxytocin (Pitocin) or through endogenous oxytocin release prompted by nipple self-stimulation.
Throughout the test, both the FHR and uterine activity are continuously recorded using external electronic monitors.

Option A: CST is typically performed using an external fetal monitor, not an internal one. Internal monitoring is invasive and requires ruptured membranes, which is not standard for this test.
Option B: A treadmill is not used in an obstetric CST. This method is completely unrelated to fetal surveillance and is characteristic of a cardiac stress test.
Option D: Leopold's maneuvers are a set of four abdominal palpations used to determine the fetus's lie, presentation, and position. They are a physical assessment technique and do not stimulate uterine contractions.

Clinical Relevance

Nursing practice connection: Use the key finding related to Procedure and Interpretation of Contraction Stress Test (CST) to guide bedside assessment, documentation, and the next nursing action.
A 'Positive' CST, identified by repetitive late decelerations, is a significant finding that indicates uteroplacental insufficiency. This means the fetus may not receive enough oxygen during labor, increasing the risk for fetal distress and prompting consideration for a cesarean delivery.
A 'Negative' CST is highly reassuring, suggesting the fetus has adequate placental reserve and is likely to tolerate the stress of labor well.
Nursing responsibilities during a CST include obtaining baseline vitals, ensuring proper monitor placement, carefully titrating oxytocin (if used) to avoid uterine hyperstimulation, and continuously monitoring for non-reassuring FHR patterns or excessive contractions.

How to Approach the Question

First, identify the core of the question: It asks for an accurate description of a Contraction Stress Test (CST).
Recall the purpose of a CST: to 'stress' the fetus with uterine contractions and monitor its heart rate response to check placental function.
Think about how contractions are safely induced for this test. The two standard methods are medication (oxytocin) and natural stimulation (nipple stimulation).
Consider how the fetus is monitored. This is a non-invasive screening test, so external monitors are used.
Evaluate each option based on these key points:
Option A is incorrect because it mentions an 'internal' monitor.

Concept Tested & Keywords

Concept Tested: Procedure and Interpretation of Contraction Stress Test (CST)
Stem keywords: Contraction stress test, pregnant client, nurse, test
Lead-in keywords: tells the client that
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 49-57

E6 Obstetrics Williams p. 69-95

Practise the full SJH Nursing Officer - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.