EFM NCC Test Exam MODULE 009 Question and Answers 2023 Verified 100%

Why use fetal monitoring? correct answers Primary goal is to prevent fetal and maternal morbidity and mortality (prevent injury and death to mother and/ or baby), to prevent bad patient outcomes. What percent of babies who experience a suboptimal event while being fetal monitored, develop cerebral palsy? correct answers 3% of babies with poor tracing develop cerebral palsy What are most sentinel events due to? correct answers Poor communication between providers. Most errors are traceable back to communication errors. Sentinel events correct answers bad things that happen to patients due to a human or equipment error, and not due to the reason that they came into the hospital (disease process) Equipment correct answers your hands (palpation) use fingertips, ultrasound transducer, FSE, tocodynamometer, Intrauterine Pressure Catheter, Auscultation (fetoscope, hand held doppler device). What if you can not get contractions? correct answers palpate and readjust IUPC resting tone correct answers 20-25 IUPC resting tone with aminoinfusion correct answers should not be above 40, troubleshoot if this is higher, weigh pads, make sure there is fluid return. Not meant for meconium or thick mec, they are used for variables or recurrent variables correct answers amnioinfusion Auscultation tools correct answers intermittent monitoring, use fetoscope or hand help doppler to trace. Only true auscultation tool correct answers fetoscope, the reason is it is the only tool that listens to the open and close of the fetal heart valve Using the doppler or fetoscope correct answers count the FHR before, during, and after a contraction. Document the baseline rate (range), regular vs irregular, increases or decreases. Do NOT document variability, accels, or decels doppler category 1 correct answers normal FHR baseline, regular rhythm, presence of increases from FHR baseline, no decreases from baseline doppler category 2 correct answers includes ANY of the following: irregular rhythm, presence of FHR decreases, tachycardia, bradycardia (i feel the need to intervene, I feel like I can't walk out of the room) doppler category 3 correct answers there is none! auscultation because there is no variabile determination with auscultation goal of external EFM correct answers external monitoring: goal is to detect fetal heart movement (efm) Autocorrelation correct answers how the monitor adjusts with every third beat using a mathematical formula, that it is still monitoring this baby. Detected what is normal for this baby and is making the appropriate adjustments. What does the FSE measure? correct answers Directly monitors R to R ratio (with scalp lead), definitively measures baby's heartbeat and when the heart is firing Narrow R-R interval correct answers fetal tachycardia Prolonged R-R interval correct answers fetal bradycardia FSE contraindications correct answers communicable diseases: hepatitis and HIV Normal uterine activity correct answers Normal activity: less than 5 ctx in a 10 minute period averaged over a 30 minutes period (5,5,6 OK but 6,5,6 NOT OK) Excessive uterine activity correct answers Tachysystole (not hyperstim), hypertonus (with IUPC resting tone does not go below 20 mmHG-IUPC, 20-25mmhg shouldn't be higher..if higher usually due to inadequate relation time), inadequate relaxation time, tetanic contractions(cxn greater than 2 minutes) What do you do with tachysystole? correct answers turn down pitocin (reposition etc) Reduce blood flow through the intervillous space correct answers Mild Contractions (30 mmHG) No blood flow through the intervillous space correct answers Moderate Contractions (50 mmHG) Adequate MVUS correct answers 200-300...greater than 200, spontaneous labor less than 280 for the first stage but up to 400 for the second stage. Typically less than 300 (so 200-300). Importance of doing multiple interventions sooner than later correct answers you see tachysystole or deceleration, turn pitocin off & IV bolus & resposition. Multiple interventions are important. Why would it be in your best interest to bolus, turn off pit, and reposition? correct answers will resolve tachysystole and decelerations faster Troubleshooting tips? correct answers check cables, check connections (avoid wrapping too tightly), check patient position/ fetal position, palpate abdomen, check maternal pulse, listen to maternal hr vs fetal hr, run the monitors self test feature, document what you did! Monitoring patients FHR, after assessment done for admission, you see FHR that is tracing 90 for the last 30 minutes. What would you do? correct answers Verify maternal HR. If bradycardic tracing, always verify maternal heart rate