A nurse is reinforcing teaching with a client who is at 30 weeks of gestation and scheduled for a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?
A.
“I need to schedule the test when the baby is usually active.”.
B.
“The baby’s heart rate will be monitored during the test.”.
C.
“I will have to lie on my back during the test.”.
D.
“I will be able to go to the bathroom during the test as necessary.”.
The Correct answer and Explanation is:
Correct Answer: C. “I will have to lie on my back during the test.”
Explanation:
The nonstress test (NST) is a common prenatal test used to assess fetal well-being, particularly in the third trimester of pregnancy. The test is non-invasive and measures fetal heart rate in response to fetal movements, providing insight into how well the fetus is oxygenated and whether it is under any stress. Understanding the correct positioning and what to expect during the test is essential for the client, as proper positioning helps avoid complications like supine hypotensive syndrome.
Rationale for Incorrect Responses:
- A. “I need to schedule the test when the baby is usually active.”
This statement is accurate because the test is more effective when the fetus is active. Fetal movements are essential during the NST, as the primary goal is to observe whether the fetal heart rate increases with movement. This increase is a sign of a healthy and well-oxygenated fetus. - B. “The baby’s heart rate will be monitored during the test.”
This statement is correct as well. The NST involves continuous electronic fetal heart rate monitoring using an external transducer placed on the mother’s abdomen. The heart rate patterns provide critical information about fetal health. - D. “I will be able to go to the bathroom during the test as necessary.”
This statement is also correct. While the client should try to use the restroom before the test begins, if necessary, she can pause the test briefly to go to the bathroom.
Explanation of the Correct Answer:
- C. “I will have to lie on my back during the test.”
This statement indicates a need for further teaching because lying flat on the back is not the recommended position for a pregnant woman, especially in the third trimester. This position can lead to supine hypotensive syndrome, where the weight of the gravid uterus compresses the inferior vena cava, leading to reduced blood flow to the heart, decreased cardiac output, and lower blood pressure. This can cause dizziness, shortness of breath, and even fetal distress due to reduced placental perfusion.
The recommended position during an NST is either semi-Fowler’s, where the client is slightly reclined, or left lateral (side-lying). These positions help avoid compression of the vena cava and ensure optimal blood flow to both the mother and the fetus.
In summary, the correct answer is C because lying on the back during an NST is not advisable due to the risks associated with supine hypotensive syndrome. The client needs further education on proper positioning during the test to prevent complications and ensure accurate test results.