Cellular Regulation Flashcards
Nonstress test purpose
•Assess fetal well-being by observing changes in the fetal heart rate pattern
Nonstress test advantages
- Noninvasive
- Quick to perform
- Easy interpretation
- Inexpensive
- No contraindications or side effects
Nonstress test disadvantages
- Can be difficult to get a suitable tracing
- Woman must remain relatively still for at least 20 minutes
- High false-positive rate
- Less sensitive in detecting fetal compromise than the CST or BPP
Non stress test position
Reclining chair or bed
•Left-tilted, semi-Fowler’s, or side-lying
Nonstress test equipment
- Electronic fetal monitor
- Doppler transducer- fetal ❤️ rate ( normal 110-160)
- Toco transducer- contractions
- Handheld button to mark fetal movement
Nonstress Test Interpretation
•Reactive or NonReactive
Want Reactive Result!!
1) Shows at least TWO accelerations of FHR with fetal movements of 15 beats, lasting 15 seconds or more, over a 20 minute time period
•In preterm fetuses an acceleration is 10 beats above baseline for 10 seconds; still test for 20 minutes
2) Nonreactive= NOT at least two accelerations over 20 mins
•If fetal heart rate decelerations are noted, the health care provider needs to be notified
Acceleration
Jump UP from the FHR baseline of 15 beats (1.5 boxes up), lasting at least 15 seconds (1.5 boxes across)
Deceleration
Drop DOWN from the FHR baseline of 15 beats (1.5 boxes down), lasting at least 15 seconds (1.5 boxes across)
Nonstress test (NonReactive )
There ARE NOT at least two accelerations of FHR with fetal movements of 15 beats/min, lasting 15 seconds or more, OVER 20 minutes
Contraction Stress Test
•Purpose
- Evaluates placental respiratory function
* Identifies the fetus at risk for intrauterine asphyxia
Contraction Stress Test advantages and disadvantage
Advantages (compared to NST)
•Earlier warning of fetal compromise
•Less false-positive results
Disadvantages (compared to NST)
•More time consuming
•Expensive
•Invasive
Contraction stress test Contraindications
And what can it cause?
Should NOT be performed on women who SHOULD NOT give birth vaginally at the time the test is done
Contraindications •Preterm Labor •Placenta Previa •Vasa Previa •Cervical Insufficiency •Multiple Gestation •Classical Incision from Prior Cesarean Birth
- could induce labor or cause bleeding / uterus rupture
CST positions
Semi-Fowler or sits in a reclining chair with a slight lateral tilt
CST equipment
- Electronic fetal monitor
- Toco transducer, Doppler transducer
- Oxytocin
- Intravenous equipment and infusion pump
**Have tocolytic medication at the bedside
CST
How it’s induce? How long?
How to tell if contractions good?
Contractions likely induced with Oxytocin or self- breast stimulation
- 10-20 minute baseline recording of uterine activity and FHR obtained
- Tracing evaluated for evidence of spontaneous contractions
- If 3 spontaneous CONTRACTIONS of good quality and lasting 40 to 60 seconds occur in a 10-minute window, results are evaluated, and test is concluded