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2024 1 AWHONN FETAL HEART MONITORING BASICS EXAM WITH ANSWERS
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2024 1 AWHONN FETAL HEART MONITORING BASICS EXAM WITH ANSWERS
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2024 1 AWHONN FETAL HEARTMONITORING BASICS EXAM WITH
ANSWERS
All Fetuses of mothers in labor experience an interruption of the oxygenation
pathway at which point? - CORRECT-ANSWERSUterus
How do you alleviate umbilical cord compression? - CORRECT-
ANSWERSChange the mother's position to her side, sitting up, on hands and
knees, or a combination of position to maximize umbilical circulation.
Which contraction characteristics can be assessed with a tocodynamometer?
a) Frequency
b) Duration
c) Intensity - CORRECT-ANSWERSa) Frequency
b) Duration
Define tachysystole contractions and the cause of. - CORRECT-ANSWERS>5
contractions in 10 min (more frequently than Q 2 min) averaged over 30 min
window.
Caused by oxytocin, aminoinfusion or in rare cases spontaneously.
What do you do if variable decelerations are associated with absent FHR
variability or abnormal baseline rate and the absence of accelerations? -
CORRECT-ANSWERSrelieve cord compression, maximize umb. circulation and
rule out cord prolapse and amnioinfusion.
Admin oxygen by non-rebreather facemask, reduce or stop oxytocin to
decrease uterine activity if needed. Inform the physician if recurrent variable
decels with absent FHR baseline variability as a quick delivery may be
necessary.
What is an overshoot? - CORRECT-ANSWERSOvershoots are exaggerated
compensatory increases in FHR after a variable deceleration. Overshoots are
usually at least 10-20 BPM above baseline range and at least 20 seconds in
duration. Overshoots are usually accompanied by minimal or absent
variability and a gradual return to baseline FHR. They resemble accelerations
however unlike accels their significance to fetal acid-base status is unclear.
Explain an episodic deceleration and what causes episodic decelerations.
What are the 3 questions to ask related to episodic decels? - CORRECT-
ANSWERSIts an isolated event sometimes in conjunction with a procedure.
,May occur in response to transient cord compression, uterine tachysystole or
excessive uterine activity, administration of anesthetics, maternal position
change, or vaginal exam. By definition, they do not occur uniformly or
repetitively.
Ask 3 questions:
1. is there an obvious event that caused the decel?
2. Does FHR return to baseline when the event is over?
3. Is there moderate variability assoc. with the decleration?
What is a prolonged deceleration? - CORRECT-ANSWERSa visually apparent
decrease in FHR below the baseline rate of 15 bpm or more and lasting > 2
minutes but < 10 minutes, prolonged decels are usually isolated events that
end spontaneously. Prolonged decel's typically have an abrupt onset, reach
the nadir in <30 sec, and are in response to a sudden significant change in
the fetal environment.
IF > 10 min it is a baseline change.
With prolonged decelerations, further maternal and fetal assessment is
needed to determine if immediate intervention is needed.
Describe this tracing:
A. Accelerations
B. Early Decelerations
C. Variable decelerations
D. Late decelerations
E. Episodic deceleration - CORRECT-ANSWERSD. Late decelerations
notice the gradual decrease in baseline that follows the peak of each
contraction.
Describe the variability in this tracing:
A. Absent
B. Minimal
C. Moderate
D. Marked - CORRECT-ANSWERSA. Absent
notice the smoothness of the tracing indicating absent variability.
This tracing shows:
A. Tachycardia
B. A baseline within normal range
C. Bradycardia - CORRECT-ANSWERSB. A baseline within normal range
The baseline is 150 BPM which is within the range for normal fetal baseline
heart rate.
Define a category I (normal) fetal heart rate tracing. - CORRECT-
ANSWERSCategory I (normal) FHR tracings are normal & predictive of normal
fetal acid-base status at that time. No action is required.
, Baseline FHR rate: 110-160BPM
Baseline FHR variability: moderate
Accelerations: present or absent
Late or variable decelerations: absent
Early decelerations: present or absent
How do you rule out cord prolapse? - CORRECT-ANSWERSvaginal exam
What is Scalp Stimulation? - CORRECT-ANSWERSA method of assessing fetal
acid-base status through vigorously rubbing the fetal head with a gloved
hand to elicit an acceleration. This is dune when FHR is at baseline. Do not
do during a deceleration to attempt to increase the FHR. A well-oxygenated
fetus will respond with an acceleration of 15 BPM or more for > 15 seconds.
This is a reliable prediction of the absence of fetal metabolic acidemia at that
time. This does not predict fetal acidemia or fetal compromise. Stimulation is
not needed if the tracing has category I characteristics.
What is vibroacoustic stimulation? - CORRECT-ANSWERSThe response of the
FHR to a vibroacoustic stimulus. An acceleration on NST (> 15 bpm for > 15
sec) is a positive result.
An acceleration in response is an indicator of fetal oxygenation.
Useful adjunct to decrease the time to achieve a "reactive" NST (R-NST) and
to decrease the proportion of non-reactive NST at term, precluding the need
for further testing.
The FHR can be monitored using doppler ultrasound?
a) Throughout labor and delivery unless the use of a more accurate method
is clearly indicated
b) Internally
c) Only early in labor
d) The FHR cannot be monitored by doppler ultrasound - CORRECT-
ANSWERSa) Throughout labor and delivery unless the use of a more accurate
method is clearly indicated
What is the normal range for FHR base line in a term infant?
a) 80-120 bpm
b) 110-160 bpm
c) 140-180bpm
d) it depends on the sex of the fetus - CORRECT-ANSWERSb) 110-160 bpm
Trace the flow of oxygen from mother to fetus and back. - CORRECT-
ANSWERSMother's inhalation to lungs to mat. circulatory system to
hemoglobin in RBC's to bloodstream in uterus. Uterus to spiral arteries to
placenta to intervillous space to travel via simple diffusion into the villi. The
capillaries to the umb. vein to the fetus.
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