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Exam (elaborations)

NURS 320 - ATI Exam with verified solutions

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NURS 320 - ATI Exam with verified solutions

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NURS 320 - ATI Exam with verified
solutions

Biophysical profile (BPP): - correct answer ✔- Real-time ultrasound to visualize physical and
|||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| ||||||




physiological characteristics of the fetus |||||| |||||| |||||| |||||| ||||||




- Observes for fetal biophysical responses to stimuli
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Biophysical profile (BPP): |||||| ||||||




- Scores - correct answer ✔8-10: Normal; low risk of chronic fetal asphyxia
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4-6: Abnormal; suspect chronic fetal asphyxia
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<4: Abnormal; strongly suspect chronic fetal asphyxia
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Biophysical profile (BPP): |||||| ||||||




- Categories - correct answer ✔- Reactive FHR
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- Fetal breathing movements
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- Gross body movements
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- Fetal tone
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- Qualitative amniotic fluid volume
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,Biophysical profile (BPP): |||||| ||||||




- Indications - correct answer ✔- PROM
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- Maternal infection
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- Decreased fetal movement
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- Intrauterine growth restriction (IUGR)
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Nonstress test (NST): - correct answer ✔- Third trimester |||||| |||||| |||||| |||||| |||||| |||||| |||||| ||||||




- Antepartum evaluation of fetal well-being
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*Assesses the fetus's FHR in relationship to the fetal movement |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| ||||||




- Noninvasive procedure that monitors response of the FHR to fetal movement
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- Doppler transducer (monitor FHR) and a tocotransducer (monitor uterine contractions) are
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attached externally to a client's abdomen to obtain tracing strips
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- The client pushes a button attached to the monitor whenever she feels a fetal movement
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Nonstress test (NST): |||||| ||||||




- Results - correct answer ✔Reactive:
|||||| |||||| |||||| |||||| ||||||




- FHR is a normal baseline rate
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- Moderate variability, accelerates to 15 beats/minute for at least 15 seconds and occurs
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two or more times during a 20-minute period
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, Nonreactive:
- Fetal heart rate does not accelerate adequately with fetal movement
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- It does not meet the above criteria after 40 minutes
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- If a nonreactive result occurs, a further assessment, such as a contraction stress test (CST)
|||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| |||||| ||||||




or biophysical profile (BPP), is indicated
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Nonstress test (NST): |||||| ||||||




- Nursing Actions - correct answer ✔Position:
|||||| |||||| |||||| |||||| |||||| ||||||




- Seat the client in a reclining chair
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- Semi-Fowler's or left-lateral position
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Apply conduction gel to the client's abdomen |||||| |||||| |||||| |||||| |||||| ||||||




Apply two belts to the client's abdomen, and attach the FHR and uterine contraction
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monitors


Instruct the client to press the button on the handheld event marker each time she feels the
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fetus move
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If there are no fetal movements (fetus sleeping), vibroacoustic stimulation (sound source,
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usually laryngeal stimulator) may be activated for 3 seconds on the maternal abdomen over
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the fetal head to awaken a sleeping fetus
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Disadvantages:
- High rate of false nonreactive results due to:
|||||| |||||| |||||| |||||| |||||| |||||| |||||| ||||||




*Sleep cycles of the fetus |||||| |||||| |||||| ||||||




*Fetal immaturity ||||||

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