Question

Susan who has diabetes and is in week 36 of pregnancy has been scheduled for a non-stress test

• Discuss what you would tell susan about the purpose of this test and what will be learned about her baby’s well being

• Describe how you would prepare Susan for the test

• Discuss how you would conduct the test

• Indicate the criteria you would use to determine if the test was nonreactive or reactive

Answer 1

** Tell Susan about nonstress test(NST) that measures fetal heart rate..it is a prenatal test can be done after 26 - 28weeks of pregnancy..women with gestation diabetes doctor will conduct this test before due dates..mother will have medication for diabetes, in this case delivery should not happen after 40weeks to avoid complications..we must check baby heart rate and rhythm, oxygen supply and how it responds to baby's movement, it prevent fetal death..in this test nothing is done to place stress on the fetus during the test..

** We have to prepare Susan for the test by checking her blood pressure before the test..she has to lie on a reclining chair or table..check blood pressure at regular intervals..place two belts with monitor attached to them across the Susan abdomen..

** In that one belt will measure baby's heart rate and other belt will measure uterine contraction .Ask her to note when baby moves, when the baby moves heart rate will be measured..tell her this test will extend for more than 20minute till the baby is active for accurate results..you can stimulate the baby manually or by placing a device on the mother abdomen that makes a noise..after the procedure we can inform the results immediately .

** It can be considered as a reactive or normal before 32 weeks of pregnancy if the baby's heart beat expected to a certain level above baseline twice or more for atleast 10records each with in a 20-minutes window..At 32 weeks of pregnancy or later,baby's heart rate accelerates to some level above the baseline atleast 15seconds each within 20-minutes window..

** If it is nonreactive if baby heartbeat doesn't meet the criteria discussed above..it can be occur due to baby was inactive or asleep during the test .if test extended for 40minutes and with 39weeks of pregnancy results are nonreactive we have to deliver the baby immediately.