Potayre, Shelomith Marie E.

BSN II – H

Ateneo de Zamboanga University

College of Nursing

NURSING SKILLS OUTPUT

“CONTRACTION STRESS TEST”

Definition:

Contraction Stress Test (CST), also referred to as Oxytocin Challenge Test

(OCT), is one way of evaluating the response of the fetus to a stimulus of uterine
contraction. It is based on the principle that a healthy fetus can withstand decreased
oxygen during uterine contraction, out compromised fetus cannot; CST is generally
used after 34 weeks gestation and is usually performed before labor induction.

Purpose:

The contraction stress test helps predict how your baby will do during labor. A
normal heartbeat is a good sign that your baby will be healthy during labor.

Objectives:

1. To be able to monitor the health status of the baby during contractions when the
mother is on labor
2. To make sure that during labor of the mother the fetus can handle contractions
and get oxygen needed from the placenta.
3. To be able to induce contractions and monitor the fetus to check for heart rate
abnormalities using a cardiotocograph.

Equipment/s:

1. Cardiotocograph
2. Infusion Pump
 Note: Before OCT or CST - Perform procedures A #1 to 9; Duration 1-3 hours, averaging 90 minutes

PROCEDURE 1 2 3 4 5
1. After ensuring that the physician has informed the client, check if the
informed consent signed.
2. Prepare needed fluids and oxytocin. Have I.V. inserted. The oxytocin
bottle is piggy backed to the main line and administered with an
infusion pump for accurate infusion rate monitoring.
3. Position the client to semi-Fowler’s slightly turned to the left side (or
place a wedge pillow under the right hip)
4. Conduct external fetal and uterine contraction monitoring for 30
minutes to establish baselines of FHT and uterine activity.
5. Administer intravenous diluted oxytocin via infusion pump slowly at
first, gradually increased every 15 minutes until the woman has 3
contractions in 10 minutes period.
6. Note the effects of contractions on FHR, stop oxytocin drip if late
deceleration is noted.
7. Refer the findings to the physician.
8. Continue monitoring client.
9. Documents findings in clients file.
TOTAL

Interpretation of Findings:

 Negative – no late decelerations with 3 adequate uterine contractions, 40-60 seconds long
in a 10 minutes window; normal baseline FHR and FHR accelerations with fetal movement.
Fetus should tolerate labor if it occurs within one week.
 Positive – with persistent / consistent late deceleration with more than half the uterine
contraction, an ominous sign, STOP oxytocin drips right away then turn the client to her left.
Fetus is at risk; the fetus may have to be deliver via caesarian birth.
 Suspicious – ate deceleration with fewer than half the uterine contractions. CST is often
repeated in 24 hours or other fetal assessment tests are performed.
 Unsatisfactory – inadequate FHR recording or less than three uterine contractions in 10
minutes.

NURSING RESPONSIBILITIES:

 Nurses help mothers who are expecting, to avoid and recognize health problems that might
present before, during, or after birth.
 Nurse must ensure the safe environment of the mother and her incoming newborn.
 Nurses must assess the fetal status, including heart rate position and station.
 Nurses must assess the uterine activity, including contraction frequency, duration, and
intensity.

Illustration:

Mrs. Christine Calunod

Clinical Instructor