1 AWHONN Fetal Heart monitoring basics
Exam with verified correct answers
Which nncontraction nncharacteristics nncan nnbe nnassessed nnwith nna nntocodynamometer?
a) nnFrequency
b) nnDuration
c) nnIntensity nn- nncorrect nnanswer-a) nnFrequency
b) nnDuration
All nnFetuses nnof nnmothers nnin nnlabor nnexperience nnan nninterruption nnof nnthe nnoxygenation nnpathway nnat
nnwhich nnpoint? nn- nncorrect nnanswer-Uterus
The nnFHR nncan nnbe nnmonitored nnusing nndoppler nnultrasound?
a) nnThroughout nnlabor nnand nndelivery nnunless nnthe nnuse nnof nna nnmore nnaccurate nnmethod nnis nnclearly
nnindicated
b) nnInternally
c) nnOnly nnearly nnin nnlabor
d) nnThe nnFHR nncannot nnbe nnmonitored nnby nndoppler nnultrasound nn- nncorrect nnanswer-a) nnThroughout nnlabor
nnand nndelivery nnunless nnthe nnuse nnof nna nnmore nnaccurate nnmethod nnis nnclearly nnindicated
What nnis nnthe nnnormal nnrange nnfor nnFHR nnbase nnline nnin nna nnterm nninfant?
a) nn80-120 nnbpm
b) nn110-160 nnbpm
c) nn140-180bpm
d) nnit nndepends nnon nnthe nnsex nnof nnthe nnfetus nn- nncorrect nnanswer-b) nn110-160 nnbpm
Trace nnthe nnflow nnof nnoxygen nnfrom nnmother nnto nnfetus nnand nnback. nn- nncorrect nnanswer-Mother's
nninhalation nnto nnlungs nnto nnmat. nncirculatory nnsystem nnto nnhemoglobin nnin nnRBC's nnto nnbloodstream nnin
,nnuterus. nnUterus nnto nnspiral nnarteries nnto nnplacenta nnto nnintervillous nnspace nnto nntravel nnvia nnsimple
nndiffusion nninto nnthe nnvilli. nnThe nncapillaries nnto nnthe nnumb. nnvein nnto nnthe nnfetus.
The nnumb. nnartery nnsends nnwaste nn(CO2) nnto nnthe nnintervillous nnspace nnto nnthe nnmothers nnvenous nnsystem.
What nnfactors nnimpact nnmaternal nnoxygen nndelivery? nn- nncorrect nnanswer-1. nnMother nn(blood nnplasma,
nncardiac nnoutput, nnhemoglobin nnconcentration nn& nnO2 nnsaturation)
2. nnPlacenta/intervillous nnspace nn(uterine nncontractions nn& nncalcification's)
3. nnFetus nn(vagal nnresponse nnaka nndecel nnor nncord nncompression)
By nnwhat nn% nndoes nnmaternal nncardiac nnoutput nnincrease nnabove nnthe nnnon-pregnant nnstate nnand nnwhat
nnposition nnhelps nnthis nnuteroplacental nnblood nnflow? nn- nncorrect nnanswer-30-50%
lateral nnrecumbent nnor nnsemi-Fowler's
Define nntachysystole nncontractions nnand nnthe nncause nnof. nn- nncorrect nnanswer->5 nncontractions nnin nn10 nnmin
nn(more nnfrequently nnthan nnQ nn2 nnmin) nnaveraged nnover nn30 nnmin nnwindow.
Caused nnby nnoxytocin, nnaminoinfusion nnor nnin nnrare nncases nnspontaneously.
List nninterventions nnfor nntachysystole nncontractions. nn- nncorrect nnanswer-Maintaining nnmat. nnvolume, nnmat.
nnpositioning, nnintravenous nnhydration. nnDecreasing nnmat. nnpain/anxiety.
1. nnReposition nnpt nnto nnside.
2. nnAdmin nnIV nnfluid nnbolus.
3. nnAdmin nn0.25mg nnterbutaline nnSQ.
4. nnAdmin nnO2 nn10L nnvia nnnon nnrebreather nnface nnmask.
Describe nnpassive nndiffusion nnas nnrelated nnto nnthe nnmaternal nnplacental nnfetal nnsystem. nn- nncorrect nnanswer-
higher nnconc. nnto nnlower nnconcentration.
1.Oxygen nnfrom nnmaternal nn(higher) nnto nnfetal nncompartment nn(lower) nnto nnfetal nnhgb nnthen nntransported
nnto nnfetal nntissue.
2. nnCO2 nnreturns nnto nnintervillous nnspace nnby nnpassive nndiffusion nnand nnis nnremoved nnby nnthe nnmat. nnvenous
nnsystem.
,Maternal nnhypotension nnis nna nnpotential nnside nneffect nnof nnregional nnanesthesia nnand nnanalgesia. nnWhat
nnnursing nninterventions nncould nnyou nnuse nnto nnraise nnthe nnclient's nnblood nnpressure? nnChoose nnall nnthat
nnapply.
A) nnPlace nnthe nnwoman nnin nna nnsupine nnposition.
B) nnPlace nnthe nnwoman nnin nna nnlateral nnposition.
C) nnIncrease nnintravenous nn(IV) nnfluids.
D) nnContinuous nnFetal nnMonitor
E) nnAdminister nnephedrine nnper nnMD nnorder nn- nncorrect nnanswer-Place nnher nnin nnlateral nnposition, nn&
nnincrease nnIV nnfluids. nnIf nnno nnimprovement nnmay nnneed nnto nngive nnepi nnto nnincrease nnvascular nntone.
Define nnmaternal nnhypertension nn(gestational). nn- nncorrect nnanswer-systolic nnBP nn>= nn140mm nnhg, nna
nndiastolic nnBP>= nn90 nnmm nnhg nnor nnMAP nnof nn>=105
What nnis nnthe nnnormal nnexpected nnvalue nnfor nna nnterm nnfetal nnHGB? nn- nncorrect nnanswer-17g/dl, nnfetal nnhgb
nnhas nna nnhigher nnoxygen nnaffinity nnthan nnan nnadult nnto nndevelop nnin nnan nnoxygen nnpoor nnenvironment. nnThe
nnfetal nncirculatory nnpattern nnensures nnblood nnwith nnhigher nnO2 nnand nnnutrition nncontent nnis nndelivered nnto
nnthe nnvital nnorgans nn(brain nnand nnheart) nnto nntolerate nnthe nnstress nnof nnlabor.
detail nnthe nnumbilical nncord nn- nncorrect nnanswer-1 nnvein, nn2 nnarteries nnencased nnin nnwharton's nnjelly.
O2 nn(high nncontent) nntravels nnvia nnthe nnvein
CO2 nntravels nnvia nn2 nnarteries nnback nnto nnplacenta
Define nncord nncompression. nn- nncorrect nnanswer-A nndecrease nnof nnblood nnflow nnand nnO2 nndelivery nnto nnfetus
nn& nnincreases nnCO2 nnlevel nnin nnfetus.
Transient nncord nncompression nncan nnbe nncommon nnin nnlabor. nnVariable nnFHR nndecel's nnis nnfrequently
nnassociated nnwith nncord nncompression.
Explain nnpersistent nnor nnrecurrent nncord nncompression nnconcerns nnand nnwhat nnto nnlook nnat. nn- nncorrect
nnanswer-May nnlead nnto nnhypoxemia nnand nnfetal nnacidemia. nnThe nndepth nnof nnvariable nndeceleration's nnis
nnnot nnenough nnto nndetermine nndegree. nnEvaluate nnoxygenation nnthrough nnbaseline nnheart nnrate
nncharacteristics nnthrough nnrate, nnvariability nnand nnpresence nnor nnabsence nnof nnaccelerations.
, Explain nntransient nninterruptions nnin nnfetal nnoxygen nnsupple nnduring nnlabor. nn- nncorrect nnanswer-A nnnormal
nnpart nnof nnlabor. nnAs nncontractions nnbuild nnincreased nnuterine nnpressure nnprevents nnblood nnfrom
nnentering/leaving nnthe nnintervillous nnspace. nnDuring nnthe nnpeak nnthe nnfetus nnrelies nncompletely nnon nnits
nnoxygen nnreserve nn(an nnaerobic nnchallenge nnthat nnis nnnot nnan nnissue nnfor nna nnhealth nnfetus.
Define nnUteroplacental nninsufficiency nn(UPI) nn- nncorrect nnanswer-Chronic nndeficiency nnof nnplacenta
nnfunction, nnusually nnfrom nnan nninterruption nnof nnoxygenation nnpathway nndue nnto nnabruption, nnmat. nnhypo
nnor nnhypertension nnor nnother nnissues. nnInfant nnis nnnot nntolerant nnof nncontractions. nnCan nnresult nnin nnfetal
nngrow nnrestrictions nn(FGR)
Auscultation nnof nnFetal nnHeart nnSounds nntell nnyou nnwhat nninformation?
Where nnis nnthe nnbest nnplace nnto nnlisten? nn- nncorrect nnanswer-Assess nnbaseline nnFHR
Determine nnrhythms nn(regular nnvs nnirregular)
ID nnaccelerations nnand nndeceleration's nnbut nnnot nnthe nntype nnof nndeceleration nn(early/late/variable)
The nnfetal nnheartbeat nnis nnbest nnheard nnover nnthe nnfetal nnback.
Leopold's nnManeuvers nn- nncorrect nnanswer-Palpation nnto nndetermine nnpresentation nnand nnposition nnof nnthe
nnfetus nnand nnaid nnin nnlocation nnof nnfetal nnheart nnsounds.
Head=hard, nnround, nnmovable nnobject
Buttocks=soft nnand nnirregular nnshape
Back=smooth, nnhard nnsurface nnfelt nnon nnone nnside nnof nnthe nnabdomen
Irregular nnknobs nnand nnlumps nnon nnopposite nnside nnof nnabdomen nnmay nnbe nnhands, nnfeet, nnelbows, nnand
nnknees
Handheld nnFetal nnDoppler nn- nncorrect nnanswer-Uses nnsonar nnto nntrack nnthe nnfetal nnmyocardium nn&
nnconverts nnmovement nninto nnsound. nnIf nnplaced nnincorrectly nnmay nnpick nnup nnmaternal nnheart. nn
Perform nnLeopold's nnmaneuvers nnto nnfind nnfetal nnback, nnlocate nnheartbeat, nncount nnFHR, nncheck nnmothers
nnpulse nnand nncompare.
How nncan nnyou nndetermine nnif nnthe nnplacenta nnis nnfunctioning nnoptimally? nn- nncorrect nnanswer-ID nnrisk
nnfactors nnsuch nnas nnHTN nn(=vasoconstriction), nnMaternal nnsmoking, nnabruption, nnpost-term nnpregnancy,
nnmaternal nndiabetes nnand nnconsider nnFHR nncharacteristics
Exam with verified correct answers
Which nncontraction nncharacteristics nncan nnbe nnassessed nnwith nna nntocodynamometer?
a) nnFrequency
b) nnDuration
c) nnIntensity nn- nncorrect nnanswer-a) nnFrequency
b) nnDuration
All nnFetuses nnof nnmothers nnin nnlabor nnexperience nnan nninterruption nnof nnthe nnoxygenation nnpathway nnat
nnwhich nnpoint? nn- nncorrect nnanswer-Uterus
The nnFHR nncan nnbe nnmonitored nnusing nndoppler nnultrasound?
a) nnThroughout nnlabor nnand nndelivery nnunless nnthe nnuse nnof nna nnmore nnaccurate nnmethod nnis nnclearly
nnindicated
b) nnInternally
c) nnOnly nnearly nnin nnlabor
d) nnThe nnFHR nncannot nnbe nnmonitored nnby nndoppler nnultrasound nn- nncorrect nnanswer-a) nnThroughout nnlabor
nnand nndelivery nnunless nnthe nnuse nnof nna nnmore nnaccurate nnmethod nnis nnclearly nnindicated
What nnis nnthe nnnormal nnrange nnfor nnFHR nnbase nnline nnin nna nnterm nninfant?
a) nn80-120 nnbpm
b) nn110-160 nnbpm
c) nn140-180bpm
d) nnit nndepends nnon nnthe nnsex nnof nnthe nnfetus nn- nncorrect nnanswer-b) nn110-160 nnbpm
Trace nnthe nnflow nnof nnoxygen nnfrom nnmother nnto nnfetus nnand nnback. nn- nncorrect nnanswer-Mother's
nninhalation nnto nnlungs nnto nnmat. nncirculatory nnsystem nnto nnhemoglobin nnin nnRBC's nnto nnbloodstream nnin
,nnuterus. nnUterus nnto nnspiral nnarteries nnto nnplacenta nnto nnintervillous nnspace nnto nntravel nnvia nnsimple
nndiffusion nninto nnthe nnvilli. nnThe nncapillaries nnto nnthe nnumb. nnvein nnto nnthe nnfetus.
The nnumb. nnartery nnsends nnwaste nn(CO2) nnto nnthe nnintervillous nnspace nnto nnthe nnmothers nnvenous nnsystem.
What nnfactors nnimpact nnmaternal nnoxygen nndelivery? nn- nncorrect nnanswer-1. nnMother nn(blood nnplasma,
nncardiac nnoutput, nnhemoglobin nnconcentration nn& nnO2 nnsaturation)
2. nnPlacenta/intervillous nnspace nn(uterine nncontractions nn& nncalcification's)
3. nnFetus nn(vagal nnresponse nnaka nndecel nnor nncord nncompression)
By nnwhat nn% nndoes nnmaternal nncardiac nnoutput nnincrease nnabove nnthe nnnon-pregnant nnstate nnand nnwhat
nnposition nnhelps nnthis nnuteroplacental nnblood nnflow? nn- nncorrect nnanswer-30-50%
lateral nnrecumbent nnor nnsemi-Fowler's
Define nntachysystole nncontractions nnand nnthe nncause nnof. nn- nncorrect nnanswer->5 nncontractions nnin nn10 nnmin
nn(more nnfrequently nnthan nnQ nn2 nnmin) nnaveraged nnover nn30 nnmin nnwindow.
Caused nnby nnoxytocin, nnaminoinfusion nnor nnin nnrare nncases nnspontaneously.
List nninterventions nnfor nntachysystole nncontractions. nn- nncorrect nnanswer-Maintaining nnmat. nnvolume, nnmat.
nnpositioning, nnintravenous nnhydration. nnDecreasing nnmat. nnpain/anxiety.
1. nnReposition nnpt nnto nnside.
2. nnAdmin nnIV nnfluid nnbolus.
3. nnAdmin nn0.25mg nnterbutaline nnSQ.
4. nnAdmin nnO2 nn10L nnvia nnnon nnrebreather nnface nnmask.
Describe nnpassive nndiffusion nnas nnrelated nnto nnthe nnmaternal nnplacental nnfetal nnsystem. nn- nncorrect nnanswer-
higher nnconc. nnto nnlower nnconcentration.
1.Oxygen nnfrom nnmaternal nn(higher) nnto nnfetal nncompartment nn(lower) nnto nnfetal nnhgb nnthen nntransported
nnto nnfetal nntissue.
2. nnCO2 nnreturns nnto nnintervillous nnspace nnby nnpassive nndiffusion nnand nnis nnremoved nnby nnthe nnmat. nnvenous
nnsystem.
,Maternal nnhypotension nnis nna nnpotential nnside nneffect nnof nnregional nnanesthesia nnand nnanalgesia. nnWhat
nnnursing nninterventions nncould nnyou nnuse nnto nnraise nnthe nnclient's nnblood nnpressure? nnChoose nnall nnthat
nnapply.
A) nnPlace nnthe nnwoman nnin nna nnsupine nnposition.
B) nnPlace nnthe nnwoman nnin nna nnlateral nnposition.
C) nnIncrease nnintravenous nn(IV) nnfluids.
D) nnContinuous nnFetal nnMonitor
E) nnAdminister nnephedrine nnper nnMD nnorder nn- nncorrect nnanswer-Place nnher nnin nnlateral nnposition, nn&
nnincrease nnIV nnfluids. nnIf nnno nnimprovement nnmay nnneed nnto nngive nnepi nnto nnincrease nnvascular nntone.
Define nnmaternal nnhypertension nn(gestational). nn- nncorrect nnanswer-systolic nnBP nn>= nn140mm nnhg, nna
nndiastolic nnBP>= nn90 nnmm nnhg nnor nnMAP nnof nn>=105
What nnis nnthe nnnormal nnexpected nnvalue nnfor nna nnterm nnfetal nnHGB? nn- nncorrect nnanswer-17g/dl, nnfetal nnhgb
nnhas nna nnhigher nnoxygen nnaffinity nnthan nnan nnadult nnto nndevelop nnin nnan nnoxygen nnpoor nnenvironment. nnThe
nnfetal nncirculatory nnpattern nnensures nnblood nnwith nnhigher nnO2 nnand nnnutrition nncontent nnis nndelivered nnto
nnthe nnvital nnorgans nn(brain nnand nnheart) nnto nntolerate nnthe nnstress nnof nnlabor.
detail nnthe nnumbilical nncord nn- nncorrect nnanswer-1 nnvein, nn2 nnarteries nnencased nnin nnwharton's nnjelly.
O2 nn(high nncontent) nntravels nnvia nnthe nnvein
CO2 nntravels nnvia nn2 nnarteries nnback nnto nnplacenta
Define nncord nncompression. nn- nncorrect nnanswer-A nndecrease nnof nnblood nnflow nnand nnO2 nndelivery nnto nnfetus
nn& nnincreases nnCO2 nnlevel nnin nnfetus.
Transient nncord nncompression nncan nnbe nncommon nnin nnlabor. nnVariable nnFHR nndecel's nnis nnfrequently
nnassociated nnwith nncord nncompression.
Explain nnpersistent nnor nnrecurrent nncord nncompression nnconcerns nnand nnwhat nnto nnlook nnat. nn- nncorrect
nnanswer-May nnlead nnto nnhypoxemia nnand nnfetal nnacidemia. nnThe nndepth nnof nnvariable nndeceleration's nnis
nnnot nnenough nnto nndetermine nndegree. nnEvaluate nnoxygenation nnthrough nnbaseline nnheart nnrate
nncharacteristics nnthrough nnrate, nnvariability nnand nnpresence nnor nnabsence nnof nnaccelerations.
, Explain nntransient nninterruptions nnin nnfetal nnoxygen nnsupple nnduring nnlabor. nn- nncorrect nnanswer-A nnnormal
nnpart nnof nnlabor. nnAs nncontractions nnbuild nnincreased nnuterine nnpressure nnprevents nnblood nnfrom
nnentering/leaving nnthe nnintervillous nnspace. nnDuring nnthe nnpeak nnthe nnfetus nnrelies nncompletely nnon nnits
nnoxygen nnreserve nn(an nnaerobic nnchallenge nnthat nnis nnnot nnan nnissue nnfor nna nnhealth nnfetus.
Define nnUteroplacental nninsufficiency nn(UPI) nn- nncorrect nnanswer-Chronic nndeficiency nnof nnplacenta
nnfunction, nnusually nnfrom nnan nninterruption nnof nnoxygenation nnpathway nndue nnto nnabruption, nnmat. nnhypo
nnor nnhypertension nnor nnother nnissues. nnInfant nnis nnnot nntolerant nnof nncontractions. nnCan nnresult nnin nnfetal
nngrow nnrestrictions nn(FGR)
Auscultation nnof nnFetal nnHeart nnSounds nntell nnyou nnwhat nninformation?
Where nnis nnthe nnbest nnplace nnto nnlisten? nn- nncorrect nnanswer-Assess nnbaseline nnFHR
Determine nnrhythms nn(regular nnvs nnirregular)
ID nnaccelerations nnand nndeceleration's nnbut nnnot nnthe nntype nnof nndeceleration nn(early/late/variable)
The nnfetal nnheartbeat nnis nnbest nnheard nnover nnthe nnfetal nnback.
Leopold's nnManeuvers nn- nncorrect nnanswer-Palpation nnto nndetermine nnpresentation nnand nnposition nnof nnthe
nnfetus nnand nnaid nnin nnlocation nnof nnfetal nnheart nnsounds.
Head=hard, nnround, nnmovable nnobject
Buttocks=soft nnand nnirregular nnshape
Back=smooth, nnhard nnsurface nnfelt nnon nnone nnside nnof nnthe nnabdomen
Irregular nnknobs nnand nnlumps nnon nnopposite nnside nnof nnabdomen nnmay nnbe nnhands, nnfeet, nnelbows, nnand
nnknees
Handheld nnFetal nnDoppler nn- nncorrect nnanswer-Uses nnsonar nnto nntrack nnthe nnfetal nnmyocardium nn&
nnconverts nnmovement nninto nnsound. nnIf nnplaced nnincorrectly nnmay nnpick nnup nnmaternal nnheart. nn
Perform nnLeopold's nnmaneuvers nnto nnfind nnfetal nnback, nnlocate nnheartbeat, nncount nnFHR, nncheck nnmothers
nnpulse nnand nncompare.
How nncan nnyou nndetermine nnif nnthe nnplacenta nnis nnfunctioning nnoptimally? nn- nncorrect nnanswer-ID nnrisk
nnfactors nnsuch nnas nnHTN nn(=vasoconstriction), nnMaternal nnsmoking, nnabruption, nnpost-term nnpregnancy,
nnmaternal nndiabetes nnand nnconsider nnFHR nncharacteristics
