A non-stress test is prescribed for pregnant mother and nurse informs the woman about the procedure. The nurs… - AIIMS Bhatinda NO - 2019

AIIMS Bhatinda NO - 2019

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

A Non-Stress Test (NST) is a standard, non-invasive procedure for assessing fetal well-being during pregnancy.
The core of the procedure involves placing an external ultrasound transducer over the mother's abdomen to continuously record the fetal heart rate (FHR).
A second belt with a tocodynamometer is also applied to detect uterine contractions or fetal movements.
The nurse correctly explains that the transducer is secured over the area where the fetal heart is heard most clearly to get an accurate FHR tracing.
The principle of the test is to observe for accelerations in the FHR that occur with fetal movement, which is a sign of a healthy, well-oxygenated fetus.

Option A: This is incorrect because an NST is a non-invasive procedure. It only involves external sensors placed on the abdomen and does not break the skin or enter the body. Therefore, it does not require a specific invasive procedure consent form beyond the general consent for care.
Option B: This statement is incorrect regarding the duration. A standard NST typically lasts for 20-40 minutes. While it may be extended if the fetus is inactive, a 2-hour test followed by 2 hours of close monitoring is not the routine protocol.
Option D: This statement is incorrect as it describes a Contraction Stress Test (CST), not a Non-Stress Test. The key difference is in the name: an NST is 'non-stress,' meaning contractions are not induced. A CST involves 'stressing' the fetus by inducing contractions to evaluate its response.

Clinical Relevance

Nursing practice connection: Use the key finding related to Antenatal Fetal Surveillance: Non-Stress Test (NST) to guide bedside assessment, documentation, and the next nursing action.
Nurses play a crucial role in patient education, ensuring the mother understands the NST procedure, its purpose, and what to expect. This reduces anxiety and promotes cooperation.
Correct placement of the transducers is essential for obtaining an accurate and interpretable tracing. The nurse must locate the fetal back to find the point of maximum intensity of the FHR.
A 'reactive' NST (with at least two qualifying accelerations in 20 minutes) is a reassuring sign of fetal well-being. A 'non-reactive' test requires further evaluation.

How to Approach the Question

First, identify the key term in the question: 'Non-Stress Test' (NST).
Recall the definition and primary characteristics of an NST. The name itself is a major clue – it is 'non-stress,' meaning the fetus is not challenged.
Evaluate each option based on this core knowledge.
Eliminate Option D because it describes inducing stress (contractions), which is characteristic of a Contraction Stress Test (CST).
Eliminate Option A because an NST is known to be a non-invasive external monitoring test.
Eliminate Option B by recalling the typical duration of an NST, which is 20-40 minutes, not multiple hours.

Concept Tested & Keywords

Concept Tested: Antenatal Fetal Surveillance: Non-Stress Test (NST)
Stem keywords: non-stress test, pregnant mother, procedure
Lead-in keywords: nurse informs, nurse tells that
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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