Contraction Stress Test (CST) - Nursing Science

What is a Contraction Stress Test (CST)?

The Contraction Stress Test (CST) is a prenatal test used to assess fetal well-being. It evaluates how the fetal heart rate responds to uterine contractions, which may indicate how the fetus will cope with the stress of labor. Nurses play a critical role in preparing and monitoring patients during this test.

Why is CST Performed?

The CST is typically performed when there are concerns about the fetus's health or to predict how the fetus will handle the stress of labor. This test is often recommended if previous tests, such as the Non-Stress Test (NST), have shown abnormal results. It helps in identifying potential risks like fetal distress during labor.

How is the Test Conducted?

During a CST, the woman is placed in a comfortable position, and an external fetal monitor is attached to her abdomen to monitor the fetal heart rate and uterine contractions. Contractions are induced either through nipple stimulation or the administration of oxytocin. The test usually lasts for about 20-40 minutes.

What are the Nursing Responsibilities?

Nurses have several responsibilities during a CST. They include:
Ensuring the patient understands the procedure and its purpose, addressing any concerns or questions she may have.
Preparing the patient physically and emotionally, which includes obtaining informed consent.
Monitoring the patient and fetus throughout the test, ensuring the safety and comfort of both.
Interpreting fetal heart rate patterns and identifying any signs of fetal distress.
Documenting all findings accurately and reporting any abnormalities to the healthcare provider promptly.

What are the Possible Outcomes?

The results of a CST can be categorized as:
Negative: No late decelerations in fetal heart rate are observed, indicating that the fetus is likely to cope well with labor.
Positive: Late decelerations occur with at least half of the contractions, suggesting potential fetal distress during labor.
Equivocal or Unsatisfactory: Results are inconclusive, requiring further evaluation or repeat testing.

What are the Risks and Considerations?

While CST is generally safe, it carries some risks, such as preterm labor or uterine hyperstimulation. Therefore, it is contraindicated in certain conditions like placenta previa or previous classical cesarean section. Nurses must be vigilant in monitoring and managing any adverse reactions promptly.

How to Manage Patient Anxiety?

Undergoing a CST can be stressful for expectant mothers. Nurses can help alleviate anxiety by:
Providing clear and concise information about the procedure and its importance.
Offering reassurance and emotional support throughout the test.
Encouraging questions and ensuring the patient feels heard and understood.

Conclusion

The Contraction Stress Test is a valuable tool in assessing fetal health, and nurses play a crucial role in its administration and interpretation. By understanding the procedure, outcomes, and responsibilities, nurses can ensure the safety and well-being of both the mother and fetus, contributing to a positive prenatal care experience.

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