C-EFM
What is the primary goal of fetal monitoring? - ANSTo prevent fetal and maternal morbidity
and mortality (prevent injury and death to mother and baby)
In 2004 JCAHO Sentinel Event Alert #30 recommends - ANSStandard terminology to
prevent perinatal sentinel events
What was the root cause of perinatal/infant death or permanent disability? (72%) -
ANSCommunication
What is the only true auscultation tool available? - ANSFetoscope
What does the fetoscope do? - ANSHears opening and closing of heart valves in baby
What are the benefits of palpating? - ANSWe touch the patient and we can palpate the
strength of contraction
What are the limitations of palpating? - ANSEach person is subjective on the strength and
sometimes can be hard to feel
What does a Doppler do? - ANSOnly detects heart MOTION
Benefits of auscultation? - ANSPt has freedom to move and it's not invasive
Limitations of auscultation? - ANS-you can not determine variability
-takes time
-need to have competency
For auscultation documentation what needs to be documented? - ANSRate, Rhythm
(regular/irregular), increases or decreases from baseline
And need to listen 30 seconds before, during and after contraction
What do you NOT document for auscultation documentation? - ANSVariability and
decelerations
In the 1st stage of labor you can do intermittent monitoring on a low risk patient how often? -
ANSEvery 30 minutes
In the 2nd stage (pushing) how often can you intermittently monitor for low and high right
patients - ANSLow risk q15 min
High risk q5 min
During intermittent monitoring when do you also need to listen to FHR? - ANSDuring
interventions such as medications, SROM/AROM, cervix check, etc.
, What is the normal FHR range? - ANS110-160 bpm
Category 1 auscultation includes ALL... - ANS-normal FHR baseline
-regular rhythm
-presence of access
-absence of decels
Category 2 auscultation includes ANY of the following - ANS-irregular rhythm
-presence of decels
-tachycardia
-bradycardia
US/EFM detects? - ANSFetal heart movement
When does a baby need 15x15? - ANSAt 32 weeks
Benefits of EFM/US? - ANS-you can see what's going on with baby all the time
-we can see variability which tells about oxygenation
-gives us an objective legal record
-Non invasive
Limitations of EFM/US? - ANS-constant readjustment
-limited patient movement
-when the monitor doubles or halves the FHR
Why would the EFM/US double or halve the FHR? - ANSIf the FHR is less than 30 or
greater than 240 or the baby has a heart arrhythmia
FSE/IFM does what? - ANSDirectly monitors the R to R interval
"Ekg for baby"
FSE/IFM benefits? - ANSVery precise
Pt can have more movement
FSE/IFM limitations? - ANS-water needs to be broken
-increased infection risk
-too much hair on baby's head can cause artifact
Contraindications for FSE/IFM? - ANS-HIV
-active herpes
-placenta prévia
-undiagnosed bleeding
-thrombophelia
How can you tell the difference between artifact and an arrhythmia? - ANSArtifact is irregular
and with an arrhythmia there is regularity in spikes
What is the primary goal of fetal monitoring? - ANSTo prevent fetal and maternal morbidity
and mortality (prevent injury and death to mother and baby)
In 2004 JCAHO Sentinel Event Alert #30 recommends - ANSStandard terminology to
prevent perinatal sentinel events
What was the root cause of perinatal/infant death or permanent disability? (72%) -
ANSCommunication
What is the only true auscultation tool available? - ANSFetoscope
What does the fetoscope do? - ANSHears opening and closing of heart valves in baby
What are the benefits of palpating? - ANSWe touch the patient and we can palpate the
strength of contraction
What are the limitations of palpating? - ANSEach person is subjective on the strength and
sometimes can be hard to feel
What does a Doppler do? - ANSOnly detects heart MOTION
Benefits of auscultation? - ANSPt has freedom to move and it's not invasive
Limitations of auscultation? - ANS-you can not determine variability
-takes time
-need to have competency
For auscultation documentation what needs to be documented? - ANSRate, Rhythm
(regular/irregular), increases or decreases from baseline
And need to listen 30 seconds before, during and after contraction
What do you NOT document for auscultation documentation? - ANSVariability and
decelerations
In the 1st stage of labor you can do intermittent monitoring on a low risk patient how often? -
ANSEvery 30 minutes
In the 2nd stage (pushing) how often can you intermittently monitor for low and high right
patients - ANSLow risk q15 min
High risk q5 min
During intermittent monitoring when do you also need to listen to FHR? - ANSDuring
interventions such as medications, SROM/AROM, cervix check, etc.
, What is the normal FHR range? - ANS110-160 bpm
Category 1 auscultation includes ALL... - ANS-normal FHR baseline
-regular rhythm
-presence of access
-absence of decels
Category 2 auscultation includes ANY of the following - ANS-irregular rhythm
-presence of decels
-tachycardia
-bradycardia
US/EFM detects? - ANSFetal heart movement
When does a baby need 15x15? - ANSAt 32 weeks
Benefits of EFM/US? - ANS-you can see what's going on with baby all the time
-we can see variability which tells about oxygenation
-gives us an objective legal record
-Non invasive
Limitations of EFM/US? - ANS-constant readjustment
-limited patient movement
-when the monitor doubles or halves the FHR
Why would the EFM/US double or halve the FHR? - ANSIf the FHR is less than 30 or
greater than 240 or the baby has a heart arrhythmia
FSE/IFM does what? - ANSDirectly monitors the R to R interval
"Ekg for baby"
FSE/IFM benefits? - ANSVery precise
Pt can have more movement
FSE/IFM limitations? - ANS-water needs to be broken
-increased infection risk
-too much hair on baby's head can cause artifact
Contraindications for FSE/IFM? - ANS-HIV
-active herpes
-placenta prévia
-undiagnosed bleeding
-thrombophelia
How can you tell the difference between artifact and an arrhythmia? - ANSArtifact is irregular
and with an arrhythmia there is regularity in spikes
