awhonn fetal heart monitoring basics exam 2024

Which contraction characteristics can be assessed with a tocodynamometer?
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a) Frequency

b) Duration

c) Intensity



All Fetuses of mothers in labor experience an interruption of the
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oxygenation pathway at which point? Uterus
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The FHR can be monitored using doppler ultrasound?
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a) Throughout labor and delivery unless the use of a more accurate
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method is clearly indicated
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b) Internally

c) Only early in labor J JJ J JJ J JJ




d) The FHR cannot be monitored by doppler ultrasound
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What is the normal range for FHR base line in a term infant?
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a) 80-120 bpm J JJ




b) 110-160 bpm J JJ




c) 140-180bpm

d) it depends on the sex of the fetus
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,Trace the flow of oxygen from mother to fetus and back.
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Mother's inhalation to lungs to mat. circulatory system to hemoglobin
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in RBC's to bloodstream in uterus. Uterus to spiral arteries to
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placenta to intervillous space to travel via simple diffusion into the
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villi. The capillaries to the umb. vein to the fetus.
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The umb. artery sends waste (CO2) to the intervillous space to the
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mothers venous system. –
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What factors impact maternal oxygen delivery?
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1. Mother (blood plasma, cardiac output, hemoglobin concentration
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& O2 saturation)
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2. Placenta/intervillous space (uterine contractions & calcification's) J JJ J JJ J JJ J JJ J JJ




3. Fetus (vagal response aka decel or cord compres
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By what % does maternal cardiac output increase above the non-
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pregnant state and what position helps this uteroplacental blood flow?
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30-50%

lateral recumbent or semi-Fowler's
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Define tachysystole contractions and the cause of.
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>5 contractions in 10 min (more frequently than Q 2 min) averaged over
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30 min window.
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Caused by oxytocin, aminoinfusion or in rare cases spontaneously. –
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,List interventions for tachysystole contractions.
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Maintaining mat. volume, mat. positioning, intravenous hydration.
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Decreasing mat. pain/anxiety.
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1. Reposition pt to side. J JJ J JJ J JJ




2. Admin IV fluid bolus. J JJ J JJ J JJ




3. Admin 0.25mg terbutaline SQ. J JJ J JJ J JJ




4. Admin O2 10L via non rebreather face mask
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Describe passive diffusion as related to the maternal placental fetal system.
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1. Oxygen from maternal (higher) to fetal compartment (lower) to fetal
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JJ hgb then transported to fetal tissue.
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2. CO2 returns to intervillous space by passive diffusion and is
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removed by the mat. venous system
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Maternal hypotension is a potential side effect of regional anesthesia and
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analgesia.
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Place her in lateral position, & increase IV fluids. If no improvement
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may need to give epi to increase vascular tone
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What nursing interventions could you use to raise the client's blood
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pressure?
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Choose all that apply. J JJ J JJ J JJ




A) Place the woman in a supine position.
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B) Place the woman in a lateral position.
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C) Increase intravenous (IV) fluids. J JJ J JJ J JJ

, D) Continuous Fetal Monitor J JJ J JJ




E) Administer ephedrine per MD order J JJ J JJ J JJ J JJ




systolic BP >= 140mm hg, a diastolic BP>= 90 mm hg or MAP of >=105 -
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answer>>Define maternal hypertension (gestational).
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What is the normal expected value for a term fetal HGB?
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17g/dl, fetal hgb has a higher oxygen affinity than an adult to
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develop in an oxygen poor environment. The fetal circulatory pattern
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ensures blood with higher O2 and nutrition content is delivered to the
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vital organs (brain and heart) to tolerate the stress of labor. –
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detail the umbilical cord J JJ J JJ J JJ




1 vein, 2 arteries encased in wharton's
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jelly. O2 (high content) travels via the
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JJ vein

CO2 travels via 2 arteries back to placenta –
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Define cord compression. J JJ J JJ




A decrease of blood flow and O2 delivery to fetus & increases CO2 level
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in fetus.
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Transient cord compression can be common in labor. Variable FHR decel's
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is frequently associated with cord compression.
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Explain persistent or recurrent cord compression concerns and what to look
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at.
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