Question

During a nonstress test, the baseline fetal heart rate of 130 to 140 beats per minute rises to 160 twice and 157 once during a 20-minute period. Each of these episodes lasts 20 seconds. Which action would the nurse take?

1
Discontinue the test because the pattern is within the normal range.
2
Encourage the client to drink more fluids to decrease fetal heart rate.
3
Notify the primary health care provider and prepare for an emergency birth.
4
Record this nonreassuring pattern and continue the test for further evaluation.

Answer 1

The correct action would be to discontinue the nonstress test as the fetal heart rate pattern is within the normal range, showing typical accelerations without indications of fetal distress.

Step-by-step explanation:

During a nonstress test, the baseline fetal heart rate (FHR) of 130 to 140 beats per minute that rises episodically to 160 and 157 bpm, with each episode lasting 20 seconds, reflects normal fetal reactivity during a 20-minute period. The nonstress test is a common prenatal test used to check on a baby's health. In this context, a FHR that accelerates with fetal movements and then returns to the baseline range is considered reassuring. These brief accelerations of the heart rate indicate good fetal oxygenation and a healthy autonomic nervous system.

In the scenario described, the correct action would be to discontinue the test because the pattern is within the normal range. This would correspond to the first option provided. There is no need to encourage the client to drink more fluids, notify the health care provider for emergency birth, or record this as a nonreassuring pattern. The test results suggest that the fetus is not in distress, and an increase to 160 bpm in the context of a nonstress test is not typically indicative of tachycardia or an impending emergency.