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NonStress test vs. Contraction Stress tests - Fetal Heart Rate Monitoring - NCLEX Highyield -Archer

all right this video is going to review

the non-stress test and contraction

stress tests that are both done on

pregnant women to help kind of determine

the oxygenation being delivered to the

placenta it can be a little bit

confusing which one is indicated when so

we're gonna break each of them down how

they're performed when they're indicated

and what the results look like so we'll

start off with our non-stress test this

is the less invasive invasive of the two

and it's going to be performed on pretty

much all women

so the non-stress test assesses

placental function and oxygenation how

much oxygen is being delivered to the

fetus through that placenta that in turn

determines fetal well-being and we're

doing this by evaluating both the fetal

heart rate and how it's responding to

the fetus moving next thing we want to

know is how exactly that test is

performed so for the non-stress test

external ultrasound transducers and

Tocco Dino meters are going to be

applied to the mother that external you

ultrasound transducer will be picking up

the fetal heart rate and the Tocco

dynamit are is going to be picking up on

uterine contractions any movement within

the mother so we're gonna do it tracing

of at least 20 minutes for the

non-stressed test it can be up to 40

minutes but 20 minutes is standard and

all that needs to be done is simply

watch the fetal heart rate and the

uterine activity to evaluate the fetuses

response to movement next thing we need

to do is evaluate that response to the

movement so we have three categories

reactive nonreactive and unsatisfactory

we'll start off with reactive this is a

normal response for a stress test and

yeah it means we have a healthy baby to

have a reactive non-stress test we need

at least two accelerations of 15 by 15

in the fetus that means there needs to

be an increase in the heart rate by 15

beats per minute for at least 15 seconds

in response to movement in response to a

contraction by the mother um that

movement is what is going to make our

test reactive so then on the flip side

the other result that can occur is an

unreactive test or a numb excuse me

nonreactive non-stress test and this is

abnormal not good we do not have a

healthy baby and this warrants further

testing for a non-stress test to be

nonreactive

we can't have any accelerations or we

can have less than two accelerations of

15 by 15 in a 40-minute period that's

why I said sometimes the non-stressed

tests can be extended out to 40 minutes

if we're waiting to see if we're gonna

get anything we will wait an additional

20 minutes but this indicates the need

for a contraction stress test which we

will speak about next lastly we can have

an unsatisfactory result this just means

that our results can't be read due to

poor quality and the test needs to be

repeated moving on to our constraction

stress test this also assesses placental

oxygenation and function but

additionally it's going to determine the

fetal fetuses ability to tolerate labor

this is because we're going to induce

contractions and expose the fetus to the

stress of a simulated labor so we're

gonna find out if placental perfusion is

adequate when there are contractions

occurring and how fetal well-being will

look during labor we really only perform

a contraction stress test if the

non-stressed test is abnormal now

performing a contraction stress test

will not look much different than the

non stress test with the key difference

of we're going to be administering

pitocin to stimulate contractions so

there will still be an external fetal

monitor applied to the mother we will

record a 20-minute baseline strip and

then we will administer our christos in

and start to stimulate those

contractions now to get a quality read

we need at least three contractions

lasting 40 second

or more within ten minutes of each other

so that's how much and how the intensity

of the contractions we need to be seeing

to proceed with this contraction stress

test again we will be monitoring the

fetal heart rate and its response to

these contractions alright last thing

for us to go over will be the results of

the contraction stress test we can have

negative positive equivocal or

unsatisfactory so we'll start off with a

negative contraction stress test this is

normal

yay we have a healthy baby the way that

we interpret this test as negative is

that there were no late decelerations in

response to those contractions we

induced with the mother now to learn

more about late decelerations please see

the separate video regarding fetal heart

rate monitoring I dive much more into

that there but for the purpose of a

contraction stress test it will be red

negative or normal if we have no late

decelerations on the flip side if we

have a positive contraction stress test

this is abnormal that means we did have

late decelerations

with 50% or more of the contractions so

just say for example the mother had 10

contractions during her contraction

stress test if the fetus had 6 7 8

decelerations

specifically late decelerations with

those contractions the tests would be

read as positive this is abnormal and is

a bad sign it really does mean the fetus

isn't tolerating a simulated labor and

that's not good we need to further

evaluate why that's happening especially

before labor starts of course now my

last two results equivocal this is kind

of somewhere in the middle it means we

did have some late decelerations but

with less than 50% of the contractions

so going back to our previous example if

we had 10 contractions anything 4 or

less late decelerations with those 10

contractions would be read as equivocal

most likely the doctor is going to

decide to repeat this test and see if we

can get a definitive result

lastly on unsatisfactory just means that

the tracing was bad or potentially we

could not induce those contractions and

therefore the results simply can't be

read alright that wraps up our video on

non stress tests and contraction stress

tests hopefully that information

prepares you for anything that NCLEX

could throw your way