AWHONN Advanced FHM Course Exam Answers 100%
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CASE STUDY A) SILVIA. Silvia, a 28-year-old G1P0000 at 39 1/7 weeks by sonogram, and her
partner arrived on the labor unit at 0730 for scheduled induction for IUGR/FGR. Silvia's family
history is negative for medical problems with the exception of her mother's long-term history
of diabetes. Silvia has no history of medical problems and she has never had any surgeries.
She developed gestational diabetes with this pregnancy, but her other prenatal labs were all
normal. During one of the ultrasound examinations performed to evaluate the IUGR/FGR, a
single umbilical artery was noted. On her most recent biophysical profile (BPP), the amniotic
fluid index (AFI) was 11 cm (AFI less than 5 cm is defined as oligohydramnios) and the
estimated fetal weight (EFW) was 2524 grams (7th percentile). WHAT FETAL HEART RATE
DECELERATION IS MORE LIKELY TO OCCUR IN THE PRESENCE OF SILVIA'S SINGLE UMBILICAL
ARTERY? Correct Ans-Variable decelerations
The single umbilical artery impacts which component of the oxygen transfer system?
Correct Ans-Oxygen delivery
Which of Silvia's findings indicates a potential for chronic fetal hypoxemia? Correct Ans-
Intrauterine growth restriction (IUGR)
With the finding of a single umbilical artery, what would you expect to occur with fetal
perfusion? Correct Ans-Decreased blood perfusion from the fetus to the placenta
Silvia's admission vital signs were BP 109/60, pulse 83 bpm, respirations 18/minute,
temperature 97F (36.6C). Vaginal examination findings were 2-3 cm dilated, 50% effaced, -1
station, membranes intact, and cephalic presentation. External electronic fetal monitor
devices were placed (ultrasound and tocodynamometer). She denied having contractions,
, AWHONN Advanced FHM Course Exam Answers 100%
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vaginal leaking or bleeding. Following this admission tracing, oxytocin was ordered and
initiated at 2 mU/min. Within an hour, the rate was increased to 5 mU/min. PRIMARY
BENEFITS ASSOCIATED WITH THE USE OF STANDARDIZED TERMINOLOGY FOR FHM
INTERPRETATION IN THE CLINICAL SETTING INCLUDE: Correct Ans-Enhanced
communication among health care providers and promotion of patient safety
Refer to tracing A-1. Which is the correct assessment of the admission tracing? Correct
Ans-Moderate variability
Refer to tracing A-1. Based on this tracing, a necessary intervention would be to: Correct
Ans-Readjust the toco
Refer to tracing A-2. Oxytocin was infusing at 5 mU/min when the provider arrived and
ordered the oxytocin increased to 8 mU/min. A CORRECT INTERPRETATION OF THIS TRACING
IS: Correct Ans-An oxygenated, neurologically intact fetus
Refer to tracing A-2. A high-priority intervention at this time is to: Correct Ans-Readjust
the toco
One hour later, the nurse observed two 3 cm sized, thick dark blood clots on the under pad.
Silvia denied pain and her abdomen was soft to palpation. Which component of oxygen
transport to the fetus could potentially be compromised by this bleeding? Correct Ans-
Delivery
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