AWHONN INTERMEDIATE FETAL MONITORING EXAM LATEST
ACTUAL EXAM
when do you assess FHR - ANSWER: during labor
Prior to labor stimulants, periods of ambulation, administration of medications,
initiation of anesthesia
following ROM, vaginal exams, periods of ambulation, and procedures such as
enemas and caths
why do you assess FHR? - ANSWER: to recognize abnormal uterine patterns, evaluate
effects of Pitocin and other meds
what are the two methods of fetal monitoring? - ANSWER: intermittent (auscultation
with fetoscope or doppler)
electronic/continuous (External toco transducer with ultrasound, internal scalp
electrode with IUPC)
intermittent fetal monitoring - ANSWER: low risk, one-to-one nurse-to-pt ratio, non
invasive, mom can be ambulatory
disadvantages of intermittent fetal monitoring - ANSWER: Is a learned skill
May miss detection of information with a weak signal or movement of mom and
baby
Difficult to identify periodic changes
Difficult to detect variability
No printed record other than nursing documentation
AWHONN and ACOG Standards for Intermittent fetal monitoring - ANSWER: for high
risk mom: stage I - Q30min, stage II - Q15min
for low risk mom: stage I - Q15min, stage II - Q5 min
advantages of EFM - ANSWER: Continuous information
Variability can be determined
Printed record as long as mom is on the monitor
disadvantages of EFM - ANSWER: Requires advanced assessment and clinical
judgment skills
Has a history of controversy for interpretation and interventions Restriction of
mom's activity
Expensive
May increase C/S rate, infections
Use should be based on risk assessment but also is based on obstetric staff
preference and hosp policy
, AWHONN standards for EFM - ANSWER: Initiation of monitoring and ongoing
evaluation only by licensed healthcare providers
Fetal heart rate monitoring includes:
Application of monitoring components
Initial assessment of mother and fetus
Intermittent auscultation
Ongoing monitoring and interpretation
Clinical interventions
RISK FACTORS to consider for EFM - ANSWER: Maternal Risk Factors
Fever
Infection
Preeclampsia
Any disease process
Grand multiparity
Previous C/S
Fetal Risk Factors
Decreased movement
Meconium
Post dates
IUGR
Abnormal presentation
Multiples
Uterine Risk Factors
Dysfunctional labor
Failure to progress
Use of Pitocin
Uterine anomalies
Complications
Prolonged ROM
Premature labor
Premature ROM
Preterm labor
Previa/abruption
Regional Anesthesia
low O2 in blood to Asphixia - ANSWER: hypoxemia to hypoxia to acidemia to acidosis
to asphyxia
baseline FHR normal is what? how do you assess this? - ANSWER: 110-160 bpm
To Assess: Mean FHR in a 10 min and rounded to increment of 5 i.e. 125, 130, 135
etc.
Must have at least 2 min. of identifiable baseline segment
FHR: Tachycardia - ANSWER: FHT over 160 for 10 min or more
Considered an ominous sign if accompanied by other poor patterns
ACTUAL EXAM
when do you assess FHR - ANSWER: during labor
Prior to labor stimulants, periods of ambulation, administration of medications,
initiation of anesthesia
following ROM, vaginal exams, periods of ambulation, and procedures such as
enemas and caths
why do you assess FHR? - ANSWER: to recognize abnormal uterine patterns, evaluate
effects of Pitocin and other meds
what are the two methods of fetal monitoring? - ANSWER: intermittent (auscultation
with fetoscope or doppler)
electronic/continuous (External toco transducer with ultrasound, internal scalp
electrode with IUPC)
intermittent fetal monitoring - ANSWER: low risk, one-to-one nurse-to-pt ratio, non
invasive, mom can be ambulatory
disadvantages of intermittent fetal monitoring - ANSWER: Is a learned skill
May miss detection of information with a weak signal or movement of mom and
baby
Difficult to identify periodic changes
Difficult to detect variability
No printed record other than nursing documentation
AWHONN and ACOG Standards for Intermittent fetal monitoring - ANSWER: for high
risk mom: stage I - Q30min, stage II - Q15min
for low risk mom: stage I - Q15min, stage II - Q5 min
advantages of EFM - ANSWER: Continuous information
Variability can be determined
Printed record as long as mom is on the monitor
disadvantages of EFM - ANSWER: Requires advanced assessment and clinical
judgment skills
Has a history of controversy for interpretation and interventions Restriction of
mom's activity
Expensive
May increase C/S rate, infections
Use should be based on risk assessment but also is based on obstetric staff
preference and hosp policy
, AWHONN standards for EFM - ANSWER: Initiation of monitoring and ongoing
evaluation only by licensed healthcare providers
Fetal heart rate monitoring includes:
Application of monitoring components
Initial assessment of mother and fetus
Intermittent auscultation
Ongoing monitoring and interpretation
Clinical interventions
RISK FACTORS to consider for EFM - ANSWER: Maternal Risk Factors
Fever
Infection
Preeclampsia
Any disease process
Grand multiparity
Previous C/S
Fetal Risk Factors
Decreased movement
Meconium
Post dates
IUGR
Abnormal presentation
Multiples
Uterine Risk Factors
Dysfunctional labor
Failure to progress
Use of Pitocin
Uterine anomalies
Complications
Prolonged ROM
Premature labor
Premature ROM
Preterm labor
Previa/abruption
Regional Anesthesia
low O2 in blood to Asphixia - ANSWER: hypoxemia to hypoxia to acidemia to acidosis
to asphyxia
baseline FHR normal is what? how do you assess this? - ANSWER: 110-160 bpm
To Assess: Mean FHR in a 10 min and rounded to increment of 5 i.e. 125, 130, 135
etc.
Must have at least 2 min. of identifiable baseline segment
FHR: Tachycardia - ANSWER: FHT over 160 for 10 min or more
Considered an ominous sign if accompanied by other poor patterns
