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CEFM Exam Study Guide Questions with 100% Correct Answers | Verified | Latest Update
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CEFM Exam Study Guide Questions with 100% Correct Answers | Verified | Latest Update
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CEFM Exam Study Guide Questions with100% Correct Answers | Verified | Latest
Update
DescribeiFetaliHeartiRateiMonitoringi-iCorrectiAnswer-
EFMimayibeiexternal,iinternalioriaicombination
InitheiUS,itheimajorityiofiwomenihaveiEFMiduringisomeiorialliofitheirilab
ors
Eachimodalityihasibothiprosiandicons
DescribeiDoppleriUltrasoundi-iCorrectiAnswer-
TheidoppleriUSitransduceriisiuseditoiassessiFHRicharacteristicsiandipatt
erns.iTheitransduceritranslatesisoundiwaveireflectionsiintoiwaveformsi
whichiareiinterpretedibyiaicomputerianditheniexportediasianiaudibleiso
undiandiaiwaveformipattern.
Problems:iFHRiartifact,idoubling,ihalving,iandidetectioniofimaternalihea
rtirate
CurrentiultrasoundiFHRisignaliprocessingiusesiautocorrelationitechniqu
esiandiinterpretationiofiEFMidataiisibasedionithisiassumption
Describeiinternalifetalielectrodei-iCorrectiAnswer-
TheiFSEidirectlyimeasuresitheiFHRibyimeasuringiRitoiRiwavesiinisuccessi
,veiQRSicomplexes.iToiplaceianiFSE,iadequateicervicalidilationi(usuallyiati
leasti2icm)iandiROMiareineeded.
Contraindications:iplacentaiprevia,ihemophilia,imaternaliHIV,iherpesiin
fections,ioriwhenipresentingipartiisinotiidentifiable
Problems:iartifact,islightiriskiofifetaliinfection/injury,idoublingiorihalvin
giofitheiFHR,iandipickiupiofitheiMHRiwithifetalidemise
Otherirelativeicontraindications:isyphilis,igonorrheai(notirecommende
dibutimayibeiplacediifiaiclearibenefititoiaimotheriandifetusicanibeidemon
stratedibyiitsiuse)
Describeiexternaliuterineimonitoringi-iCorrectiAnswer-
Theitocotransduceri(TOCO)iisiaipressureisensitiveibutton-
likeideviceithatidetectsichangesiinitheiabdominalicontouriwhenithereiisi
aiuterineicontraction.iTheispecificilocationiisideterminedibyiabdominali
palpationiandiisiideallyiaismoothipartiofitheiuterusiwhereinoifetalismalli
partsiareifelt.iUsuallyithisiisitheifundusioriwhateveriuterineicontractionsi
areimostieasilyipalpated
TheiTOCOicanibestiprovide:irelativeistrength,iapproximateiduration,ian
diapproximateifrequencyioficontractionsibuticannotidetermineiactualiin
tensity.iPALPATIONiISiESSENTIAL
,Problems:iincludeiitsiinherentilimitations,ipossibilityiofiinvertedicontrac
tionsiandiissuesiwithiobesity
Describeiinternaliuterineimonitoringi-iCorrectiAnswer-
IUPCiallowsiforigreateriquantitativeimeasurementiofiuterineicontractio
nifrequency,iduration,iandiintensityioripeakiintrauterineipressureiandire
stingitone
Threeitypes:ifluid-filledi(othericountries),itransducer-tipped,iandiair-
couplediorisensor-tippedi(whatiweiused)
Measures:iactualipressuresiinimmHgiandimostiallowiforiamnioinfustion
Indicationsiforiuse:iNeediforiamnioinfusion,ititrationiofioxytociniforiind
uctionioriaugmentationiwheniexternalimethodsiareinotiprovidingienoug
hiinformation,iandilackiofiprogressiinilabor
Problems:iuserierror,idisplacement,iplacentaliabruption/shearing,iandi
aismalliriskiofiuterineiperforation
WhatiareitheithreeitypesiofiIUPCimonitors?i-iCorrectiAnswer-Fluid-
filled:ialsoicalleditheiwatericolumnimethod,iwasithei1stitypeiofiIUPCiavai
lableiandiuseidramaticallyidecreasediafteriintroductioniofitheitransduce
r-
tippedicatheter.iItiworksibyitransmittingitheipressureigeneratedibyiaico
ntractionithroughiaiwatericolumnitoiaitransducerilocatediawayifromithei
, sourceiofipressure,itypicallyiatitheimonitorisite.iThisidisplacedifluidiexer
tsipressureiagainstiaidiaphragmiinitheitransducer,igeneratingichangesiini
theielectricaliresistanceiofiaiseriesiofiwires.iTheseielectricalichangesiarei
converteditoimeasuresiofipressure.
Transducer-tipped:iIntroducediinithei1980siasianialternativeitoifluid-
filled.iTheiforceiexertedibyiaiuterineicontractioniisiconverteditoianielectr
icalisignalithatiisitransmittedithroughiaiwireisystemitoiaifetalimonitoriwh
ereitheiuterineiactivityiisidisplayedigraphicallyionitheifetalimonitoritraci
ng
Sensor-tipped:iAir-
couplingitechnology,iwhichiisiainewerimethodiofiIUPCimonitoring,iusesi
aidistallyimountediflexibleiballooniinitheiuterusiconnecteditoianiexterna
lireusableitransduceriinitheimonitoricable.iSimilaritoinoninvasiveibloodi
pressureimonitors,ithisicathetericonsistsiofiaimembraneisensoriatitheiti
piofitheicatheterithaticommuniatedipressuresithroughiaimicrocolumniof
iairitoiaitransducerilocatedioutsideitheibody
WhatiisitheipaperispeediforiEFMitracing?i-iCorrectiAnswer-
Changesiinipaperispeedicanisubstantiallyialteritheiappearanceiofitheitra
cing.iTheicommonlyiusedipaperiinitheiUSihasimarkingsionitheiverticalisca
leifromi30-240ibpmiwithidividingilinesiati10-
bpmiintervals.iShouldibeisetitoi3cmionitheihorizontaliscalei(slowerithani
Europe)
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