Non stress test - Remediation for Maternal Newborn ATI exam. PDF

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Summary

Remediation for Maternal Newborn ATI exam....

Description

ACTIVE LEARNING TEMPLATE:

Diagnostic Procedure

Celeste Godfrey STUDENT NAME _____________________________________ Non-Stress Test PROCEDURE NAME ____________________________________________________________________ REVIEW MODULE CHAPTER ___________

Description of Procedure Most widely used technique for antepartum evaluation of fetal well-being performed during the third trimester. This procedure is non-invasive and monitors the response of the FHR to fetal movement. Doppler transducer and tocotransducer, monitoring FHR and uterine contractions, respectively, are attached externally to the client's abdomen. The client pushes a button attached to the monitor whenever she feels her baby move, which is then noted on the tracing. This allows the nurse to assess FHR relationship to fetal movement.

Indications Assessing for intact fetal CNS during the third trimester. Ruling out the risk for fetal death in clients who have diabetes mellitus. Used twice a week or until after 28 weeks gestation.

Interpretation of Findings The non-stress test, or NST, is interpreted as reactive if the FHR is a normal baseline rate with moderate variability, accelerates to 15 beats/min for at least 15 seconds, and occurse two or more times during a 20-min period. Nonreactive NST indicates that the fetal heart rate does not accellerate adequately with fetal movement. It does not meet the above criteria after 40 min. If so, further assessments such as a contraction stress test or biophysical profile is indicated.

Potential Complications Decreased fetal movement, intrauterine growth restriction, postmaturity, gestational diabetes, gestational hypertension, maternal chronic hypertension, history of previous fatal demise, advanced maternal age, sickle cell disease, isoimmunization

ACTIVE LEARNING TEMPLATES

CONSIDERATIONS

Nursing Interventions (pre, intra, post) Seat the client in a reclining chair or place in semi-Fowlers or left-lateral position. Apply conduction gel to the client's abdomen. Apply two belts to the clients abdomen and attach the FHR and uterine contraction monitors. Instruct the client to press the button on the handheld event marker each time she feels her fetus move. If there are no fetal movements (eg, the fetus is sleeping), vibroacoustic stimulation (sound source, usually a laryngeal stimulator) may be activated for 3 seconds on the belly over the fetal head to awaken a sleeping fetus.

Client Education Assure the client that this procedure is non-invasive and does not bother the baby. Ensure understanding how the monitoring works and the importance of her participation with the handheld event marker.

Nursing Interventions Conduct further assessments such as a contraction stress test (CST) or biophysical profile (BPP) if the FHR doesn't accelerate with fetal movements....