QUESTION: "A client at 36 weeks' gestation with Type 1 diabetes is scheduled for a contraction stress test. After explaining the purpose of the test, the nurse determines that the client understands the instruction when she states that the test is done to detect which of the following?"
CHOICES
( X ) a.) Cardiac anomalies.
( O ) b.) Uteroplacental sufficiency.
( X ) c.) Kidney anomalies.
( X ) d.) Amniotic fluid volume.
RATIONALE: The contraction stress test, commonly performed on high-risk clients, such as those with Type 1 (insulin-dependent) diabetes, evaluates uteroplacental sufficiency by subjecting the fetus to uterine contractions, during which fetal heart rate is monitored for changes. During contractions, the arteries supplying the placenta are compressed, causing a temporary reduction in oxygenation. A fetus with adequate oxygen reserve can tolerate the transient oxygen reductions, evidenced by the fetal heart rate remaining within normal limits. An ultrasound, not a contraction stress test, would be performed to detect cardiac anomalies. An ultrasound, not a contraction stress test, would be performed to detect kidney anomalies. An amniotic fluid index (AFI) via ultrasound, not a contraction stress test, would be performed to determine amniotic fluid volume. NURSING PROCESS STEP: Evaluation CLIENT NEEDS CATEGORY: Physiological integrity CLIENT NEEDS SUBCATEGORY: Reduction of risk potential
