AWHONN Fetal Heart monitoring basics e
u u u u u
xam 2023-24 with 100% correct answers
u u u u u
a)uFrequency
b)uDurationu-
uucorrectuansweruuWhichucontractionucharacteristicsucanubeuassesseduwithuautocodynamometer?
a)uFrequency
b)uDuration
c)uIntensity
Uterusu-
uucorrectuansweruuAlluFetusesuofumothersuinulaboruexperienceuanuinterruptionuofutheuoxygenationupathway
uatuwhichupoint?
a)uThroughoutulaboruandudeliveryuunlessutheuuseuofuaumoreuaccurateumethoduisuclearlyuindicatedu-
uucorrectuansweruuTheuFHRucanubeumonitoreduusingudoppleruultrasound?
a)uThroughoutulaboruandudeliveryuunlessutheuuseuofuaumoreuaccurateumethoduisuclearlyuindicated
b)uInternally
c)uOnlyuearlyuinulabor
d)uTheuFHRucannotubeumonitoredubyudoppleruultrasound
b)u110-160ubpmu-uucorrectuansweruuWhatuisutheunormalurangeuforuFHRubaseulineuinuautermuinfant?
a)u80-120ubpm
b)u110-160ubpm
c)u140-180bpm
d)uitudependsuonutheusexuofutheufetus
,Mother'suinhalationutoulungsutoumat.ucirculatoryusystemutouhemoglobinuinuRBC'sutoubloodstreamuinuuterus
.uUterusutouspiraluarteriesutouplacentautouintervilloususpaceutoutraveluviausimpleudiffusionuintoutheuvilli.uTheu
capillariesutoutheuumb.uveinutoutheufetus.
Theuumb.uarteryusendsuwasteu(CO2)utoutheuintervilloususpaceutoutheumothersuvenoususystem.u-
uucorrectuansweruuTraceutheuflowuofuoxygenufromumotherutoufetusuanduback.
1.uMotheru(blooduplasma,ucardiacuoutput,uhemoglobinuconcentrationu&uO2usaturation)
2.uPlacenta/intervilloususpaceu(uterineucontractionsu&ucalcification's)
3.uFetusu(vagaluresponseuakaudeceluorucorducompression)u-
uucorrectuansweruuWhatufactorsuimpactumaternaluoxygenudelivery?
30-50%
lateralurecumbentuorusemi-Fowler'su-
uucorrectuansweruuByuwhatu%udoesumaternalucardiacuoutputuincreaseuaboveutheunon-
pregnantustateuanduwhatupositionuhelpsuthisuuteroplacentalublooduflow?
>5ucontractionsuinu10uminu(moreufrequentlyuthanuQu2umin)uaverageduoveru30uminuwindow.
Causedubyuoxytocin,uaminoinfusionuoruinurareucasesuspontaneously.u-
uucorrectuansweruuDefineutachysystoleucontractionsuandutheucauseuof.
Maintainingumat.uvolume,umat.upositioning,uintravenousuhydration.uDecreasingumat.upain/anxiety.
1.uRepositionuptutouside.
2.uAdminuIVufluidubolus.
3.uAdminu0.25mguterbutalineuSQ.
4.uAdminuO2u10Luviaunonurebreatherufaceumask.u-
uucorrectuansweruuListuinterventionsuforutachysystoleucontractions.
higheruconc.utouloweruconcentration.
1.Oxygenufromumaternalu(higher)utoufetalucompartmentu(lower)utoufetaluhgbuthenutransportedutoufetalutiss
ue.
2.uCO2ureturnsutouintervilloususpaceubyupassiveudiffusionuanduisuremovedubyutheumat.uvenoususystem.u-
uucorrectuansweruuDescribeupassiveudiffusionuasurelatedutoutheumaternaluplacentalufetalusystem.
,Placeuheruinulateraluposition,u&uincreaseuIVufluids.uIfunouimprovementumayuneedutougiveuepiutouincreaseuva
scularutone.u-
uucorrectuansweruuMaternaluhypotensionuisuaupotentialusideueffectuofuregionaluanesthesiauanduanalgesia.uW
hatunursinguinterventionsucoulduyouuuseutouraiseutheuclient'subloodupressure?uChooseualluthatuapply.
A)uPlaceutheuwomanuinuausupineuposition.
B)uPlaceutheuwomanuinuaulateraluposition.
C)uIncreaseuintravenousu(IV)ufluids.
D)uContinuousuFetaluMonitor
E)uAdministeruephedrineuperuMDuorder
systolicuBPu>=u140mmuhg,uaudiastolicuBP>=u90ummuhguoruMAPuofu>=105u-
uucorrectuansweruuDefineumaternaluhypertensionu(gestational).
17g/dl,ufetaluhgbuhasuauhigheruoxygenuaffinityuthanuanuadultutoudevelopuinuanuoxygenupooruenvironment.uT
heufetalucirculatoryupatternuensuresublooduwithuhigheruO2uandunutritionucontentuisudeliveredutoutheuvitalu
organsu(brainuanduheart)utoutolerateutheustressuofulabor.u-
uucorrectuansweruuWhatuisutheunormaluexpecteduvalueuforuautermufetaluHGB?
1uvein,u2uarteriesuencaseduinuwharton'sujelly.
O2u(highucontent)utravelsuviautheuvein
CO2utravelsuviau2uarteriesubackutouplacentau-uucorrectuansweruudetailutheuumbilicalucord
AudecreaseuofublooduflowuanduO2udeliveryutoufetusu&uincreasesuCO2uleveluinufetus.
Transientucorducompressionucanubeucommonuinulabor.uVariableuFHRudecel'suisufrequentlyuassociateduwithu
corducompression.u-uucorrectuansweruuDefineucorducompression.
Mayuleadutouhypoxemiauandufetaluacidemia.uTheudepthuofuvariableudeceleration'suisunotuenoughutoudeter
mineudegree.uEvaluateuoxygenationuthroughubaselineuhearturateucharacteristicsuthroughurate,uvariabilityua
ndupresenceuoruabsenceuofuaccelerations.u-
uucorrectuansweruuExplainupersistentuorurecurrentucorducompressionuconcernsuanduwhatutoulookuat.
, Aunormalupartuofulabor.uAsucontractionsubuilduincreaseduuterineupressureupreventsubloodufromuentering/l
eavingutheuintervilloususpace.uDuringutheupeakutheufetusureliesucompletelyuonuitsuoxygenureserveu(anuaero
bicuchallengeuthatuisunotuanuissueuforuauhealthufetus.u-
uucorrectuansweruuExplainutransientuinterruptionsuinufetaluoxygenusuppleuduringulabor.
Chronicudeficiencyuofuplacentaufunction,uusuallyufromuanuinterruptionuofuoxygenationupathwayudueutouabr
uption,umat.uhypouoruhypertensionuoruotheruissues.uInfantuisunotutolerantuofucontractions.uCanuresultuinufet
alugrowurestrictionsu(FGR)u-uucorrectuansweruuDefineuUteroplacentaluinsufficiencyu(UPI)
AssessubaselineuFHR
Determineurhythmsu(regularuvsuirregular)
IDuaccelerationsuandudeceleration'subutunotutheutypeuofudecelerationu(early/late/variable)
Theufetaluheartbeatuisubestuhearduoverutheufetaluback.u-
uucorrectuansweruuAuscultationuofuFetaluHeartuSoundsutelluyouuwhatuinformation?
Whereuisutheubestuplaceutoulisten?
Palpationutoudetermineupresentationuandupositionuofutheufetusuanduaiduinulocationuofufetaluheartusounds.
Head=hard,uround,umovableuobject
Buttocks=softuanduirregularushape
Back=smooth,uhardusurfaceufeltuonuoneusideuofutheuabdomen
Irregularuknobsuandulumpsuonuoppositeusideuofuabdomenumayubeuhands,ufeet,uelbows,uandukneesu-
uucorrectuansweruuLeopold'suManeuvers
Usesusonarutoutrackutheufetalumyocardiumu&uconvertsumovementuintousound.uIfuplaceduincorrectlyumayupi
ckuupumaternaluheart.u
PerformuLeopold'sumaneuversutoufindufetaluback,ulocateuheartbeat,ucountuFHR,ucheckumothersupulseuandu
compare.u-uucorrectuansweruuHandhelduFetaluDoppler
IDuriskufactorsusuchuasuHTNu(=vasoconstriction),uMaternalusmoking,uabruption,upost-
termupregnancy,umaternaludiabetesuanduconsideruFHRucharacteristicsu-
uucorrectuansweruuHowucanuyouudetermineuifutheuplacentauisufunctioninguoptimally?
u u u u u
xam 2023-24 with 100% correct answers
u u u u u
a)uFrequency
b)uDurationu-
uucorrectuansweruuWhichucontractionucharacteristicsucanubeuassesseduwithuautocodynamometer?
a)uFrequency
b)uDuration
c)uIntensity
Uterusu-
uucorrectuansweruuAlluFetusesuofumothersuinulaboruexperienceuanuinterruptionuofutheuoxygenationupathway
uatuwhichupoint?
a)uThroughoutulaboruandudeliveryuunlessutheuuseuofuaumoreuaccurateumethoduisuclearlyuindicatedu-
uucorrectuansweruuTheuFHRucanubeumonitoreduusingudoppleruultrasound?
a)uThroughoutulaboruandudeliveryuunlessutheuuseuofuaumoreuaccurateumethoduisuclearlyuindicated
b)uInternally
c)uOnlyuearlyuinulabor
d)uTheuFHRucannotubeumonitoredubyudoppleruultrasound
b)u110-160ubpmu-uucorrectuansweruuWhatuisutheunormalurangeuforuFHRubaseulineuinuautermuinfant?
a)u80-120ubpm
b)u110-160ubpm
c)u140-180bpm
d)uitudependsuonutheusexuofutheufetus
,Mother'suinhalationutoulungsutoumat.ucirculatoryusystemutouhemoglobinuinuRBC'sutoubloodstreamuinuuterus
.uUterusutouspiraluarteriesutouplacentautouintervilloususpaceutoutraveluviausimpleudiffusionuintoutheuvilli.uTheu
capillariesutoutheuumb.uveinutoutheufetus.
Theuumb.uarteryusendsuwasteu(CO2)utoutheuintervilloususpaceutoutheumothersuvenoususystem.u-
uucorrectuansweruuTraceutheuflowuofuoxygenufromumotherutoufetusuanduback.
1.uMotheru(blooduplasma,ucardiacuoutput,uhemoglobinuconcentrationu&uO2usaturation)
2.uPlacenta/intervilloususpaceu(uterineucontractionsu&ucalcification's)
3.uFetusu(vagaluresponseuakaudeceluorucorducompression)u-
uucorrectuansweruuWhatufactorsuimpactumaternaluoxygenudelivery?
30-50%
lateralurecumbentuorusemi-Fowler'su-
uucorrectuansweruuByuwhatu%udoesumaternalucardiacuoutputuincreaseuaboveutheunon-
pregnantustateuanduwhatupositionuhelpsuthisuuteroplacentalublooduflow?
>5ucontractionsuinu10uminu(moreufrequentlyuthanuQu2umin)uaverageduoveru30uminuwindow.
Causedubyuoxytocin,uaminoinfusionuoruinurareucasesuspontaneously.u-
uucorrectuansweruuDefineutachysystoleucontractionsuandutheucauseuof.
Maintainingumat.uvolume,umat.upositioning,uintravenousuhydration.uDecreasingumat.upain/anxiety.
1.uRepositionuptutouside.
2.uAdminuIVufluidubolus.
3.uAdminu0.25mguterbutalineuSQ.
4.uAdminuO2u10Luviaunonurebreatherufaceumask.u-
uucorrectuansweruuListuinterventionsuforutachysystoleucontractions.
higheruconc.utouloweruconcentration.
1.Oxygenufromumaternalu(higher)utoufetalucompartmentu(lower)utoufetaluhgbuthenutransportedutoufetalutiss
ue.
2.uCO2ureturnsutouintervilloususpaceubyupassiveudiffusionuanduisuremovedubyutheumat.uvenoususystem.u-
uucorrectuansweruuDescribeupassiveudiffusionuasurelatedutoutheumaternaluplacentalufetalusystem.
,Placeuheruinulateraluposition,u&uincreaseuIVufluids.uIfunouimprovementumayuneedutougiveuepiutouincreaseuva
scularutone.u-
uucorrectuansweruuMaternaluhypotensionuisuaupotentialusideueffectuofuregionaluanesthesiauanduanalgesia.uW
hatunursinguinterventionsucoulduyouuuseutouraiseutheuclient'subloodupressure?uChooseualluthatuapply.
A)uPlaceutheuwomanuinuausupineuposition.
B)uPlaceutheuwomanuinuaulateraluposition.
C)uIncreaseuintravenousu(IV)ufluids.
D)uContinuousuFetaluMonitor
E)uAdministeruephedrineuperuMDuorder
systolicuBPu>=u140mmuhg,uaudiastolicuBP>=u90ummuhguoruMAPuofu>=105u-
uucorrectuansweruuDefineumaternaluhypertensionu(gestational).
17g/dl,ufetaluhgbuhasuauhigheruoxygenuaffinityuthanuanuadultutoudevelopuinuanuoxygenupooruenvironment.uT
heufetalucirculatoryupatternuensuresublooduwithuhigheruO2uandunutritionucontentuisudeliveredutoutheuvitalu
organsu(brainuanduheart)utoutolerateutheustressuofulabor.u-
uucorrectuansweruuWhatuisutheunormaluexpecteduvalueuforuautermufetaluHGB?
1uvein,u2uarteriesuencaseduinuwharton'sujelly.
O2u(highucontent)utravelsuviautheuvein
CO2utravelsuviau2uarteriesubackutouplacentau-uucorrectuansweruudetailutheuumbilicalucord
AudecreaseuofublooduflowuanduO2udeliveryutoufetusu&uincreasesuCO2uleveluinufetus.
Transientucorducompressionucanubeucommonuinulabor.uVariableuFHRudecel'suisufrequentlyuassociateduwithu
corducompression.u-uucorrectuansweruuDefineucorducompression.
Mayuleadutouhypoxemiauandufetaluacidemia.uTheudepthuofuvariableudeceleration'suisunotuenoughutoudeter
mineudegree.uEvaluateuoxygenationuthroughubaselineuhearturateucharacteristicsuthroughurate,uvariabilityua
ndupresenceuoruabsenceuofuaccelerations.u-
uucorrectuansweruuExplainupersistentuorurecurrentucorducompressionuconcernsuanduwhatutoulookuat.
, Aunormalupartuofulabor.uAsucontractionsubuilduincreaseduuterineupressureupreventsubloodufromuentering/l
eavingutheuintervilloususpace.uDuringutheupeakutheufetusureliesucompletelyuonuitsuoxygenureserveu(anuaero
bicuchallengeuthatuisunotuanuissueuforuauhealthufetus.u-
uucorrectuansweruuExplainutransientuinterruptionsuinufetaluoxygenusuppleuduringulabor.
Chronicudeficiencyuofuplacentaufunction,uusuallyufromuanuinterruptionuofuoxygenationupathwayudueutouabr
uption,umat.uhypouoruhypertensionuoruotheruissues.uInfantuisunotutolerantuofucontractions.uCanuresultuinufet
alugrowurestrictionsu(FGR)u-uucorrectuansweruuDefineuUteroplacentaluinsufficiencyu(UPI)
AssessubaselineuFHR
Determineurhythmsu(regularuvsuirregular)
IDuaccelerationsuandudeceleration'subutunotutheutypeuofudecelerationu(early/late/variable)
Theufetaluheartbeatuisubestuhearduoverutheufetaluback.u-
uucorrectuansweruuAuscultationuofuFetaluHeartuSoundsutelluyouuwhatuinformation?
Whereuisutheubestuplaceutoulisten?
Palpationutoudetermineupresentationuandupositionuofutheufetusuanduaiduinulocationuofufetaluheartusounds.
Head=hard,uround,umovableuobject
Buttocks=softuanduirregularushape
Back=smooth,uhardusurfaceufeltuonuoneusideuofutheuabdomen
Irregularuknobsuandulumpsuonuoppositeusideuofuabdomenumayubeuhands,ufeet,uelbows,uandukneesu-
uucorrectuansweruuLeopold'suManeuvers
Usesusonarutoutrackutheufetalumyocardiumu&uconvertsumovementuintousound.uIfuplaceduincorrectlyumayupi
ckuupumaternaluheart.u
PerformuLeopold'sumaneuversutoufindufetaluback,ulocateuheartbeat,ucountuFHR,ucheckumothersupulseuandu
compare.u-uucorrectuansweruuHandhelduFetaluDoppler
IDuriskufactorsusuchuasuHTNu(=vasoconstriction),uMaternalusmoking,uabruption,upost-
termupregnancy,umaternaludiabetesuanduconsideruFHRucharacteristicsu-
uucorrectuansweruuHowucanuyouudetermineuifutheuplacentauisufunctioninguoptimally?
