AWHONN Fetal Heart Monitoring Basics Exam 2024
a)zFrequency
b)zDurationz-zCORRECTzANSWER-
Whichzcontractionzcharacteristicszcanzbezassessedzwithzaztocodynamometer?
a)zFrequency
b)zDuration
c)zIntensity
Uterusz-zCORRECTzANSWER-
AllzFetuseszofzmotherszinzlaborzexperiencezanzinterruptionzofzthezoxygenationzpathwayzatzwhichzpoint?
a)zThroughoutzlaborzandzdeliveryzunlesszthezusezofzazmorezaccuratezmethodziszclearlyzindicatedz-
zCORRECTzANSWER-ThezFHRzcanzbezmonitoredzusingzdopplerzultrasound?
a)zThroughoutzlaborzandzdeliveryzunlesszthezusezofzazmorezaccuratezmethodziszclearlyzindicated
b)zInternally
c)zOnlyzearlyzinzlabor
d)zThezFHRzcannotzbezmonitoredzbyzdopplerzultrasound
b)z110-160zbpmz-zCORRECTzANSWER-WhatzisztheznormalzrangezforzFHRzbasezlinezinzaztermzinfant?
a)z80-120zbpm
b)z110-160zbpm
c)z140-180bpm
d)zitzdependszonzthezsexzofzthezfetus
Mother'szinhalationztozlungsztozmat.zcirculatoryzsystemztozhemoglobinzinzRBC'sztozbloodstreamzinzuterus.z
Uterusztozspiralzarteriesztozplacentaztozintervillouszspaceztoztravelzviazsimplezdiffusionzintozthezvilli.zThezca
pillariesztozthezumb.zveinztozthezfetus.
Thezumb.zarteryzsendszwastez(CO2)ztozthezintervillouszspaceztozthezmotherszvenouszsystem.z-
zCORRECTzANSWER-Tracezthezflowzofzoxygenzfromzmotherztozfetuszandzback.
,1.zMotherz(bloodzplasma,zcardiaczoutput,zhemoglobinzconcentrationz&zO2zsaturation)
2.zPlacenta/intervillouszspacez(uterinezcontractionsz&zcalcification's)
3.zFetusz(vagalzresponsezakazdecelzorzcordzcompression)z-zCORRECTzANSWER-
Whatzfactorszimpactzmaternalzoxygenzdelivery?
30-50%
lateralzrecumbentzorzsemi-Fowler'sz-zCORRECTzANSWER-
Byzwhatz%zdoeszmaternalzcardiaczoutputzincreasezaboveztheznon-
pregnantzstatezandzwhatzpositionzhelpszthiszuteroplacentalzbloodzflow?
>5zcontractionszinz10zminz(morezfrequentlyzthanzQz2zmin)zaveragedzoverz30zminzwindow.
Causedzbyzoxytocin,zaminoinfusionzorzinzrarezcaseszspontaneously.z-zCORRECTzANSWER-
Defineztachysystolezcontractionszandzthezcausezof.
Maintainingzmat.zvolume,zmat.zpositioning,zintravenouszhydration.zDecreasingzmat.zpain/anxiety.
1.zRepositionzptztozside.
2.zAdminzIVzfluidzbolus.
3.zAdminz0.25mgzterbutalinezSQ.
4.zAdminzO2z10Lzviaznonzrebreatherzfacezmask.z-zCORRECTzANSWER-
Listzinterventionszforztachysystolezcontractions.
higherzconc.ztozlowerzconcentration.
1.Oxygenzfromzmaternalz(higher)ztozfetalzcompartmentz(lower)ztozfetalzhgbzthenztransportedztozfetalztissu
e.
2.zCO2zreturnsztozintervillouszspacezbyzpassivezdiffusionzandziszremovedzbyzthezmat.zvenouszsystem.z-
zCORRECTzANSWER-Describezpassivezdiffusionzaszrelatedztozthezmaternalzplacentalzfetalzsystem.
Placezherzinzlateralzposition,z&zincreasezIVzfluids.zIfznozimprovementzmayzneedztozgivezepiztozincreasezvasc
ularztone.z-zCORRECTzANSWER-
Maternalzhypotensionziszazpotentialzsidezeffectzofzregionalzanesthesiazandzanalgesia.zWhatznursingzinterv
entionszcouldzyouzuseztozraisezthezclient'szbloodzpressure?zChoosezallzthatzapply.
,A)zPlacezthezwomanzinzazsupinezposition.
B)zPlacezthezwomanzinzazlateralzposition.
C)zIncreasezintravenousz(IV)zfluids.
D)zContinuouszFetalzMonitor
E)zAdministerzephedrinezperzMDzorder
systoliczBPz>=z140mmzhg,zazdiastoliczBP>=z90zmmzhgzorzMAPzofz>=105z-zCORRECTzANSWER-
Definezmaternalzhypertensionz(gestational).
17g/dl,zfetalzhgbzhaszazhigherzoxygenzaffinityzthanzanzadultztozdevelopzinzanzoxygenzpoorzenvironment.zTh
ezfetalzcirculatoryzpatternzensureszbloodzwithzhigherzO2zandznutritionzcontentziszdeliveredztozthezvitalzorg
ansz(brainzandzheart)ztoztoleratezthezstresszofzlabor.z-zCORRECTzANSWER-
WhatzisztheznormalzexpectedzvaluezforzaztermzfetalzHGB?
1zvein,z2zarterieszencasedzinzwharton'szjelly.
O2z(highzcontent)ztravelszviazthezvein
CO2ztravelszviaz2zarterieszbackztozplacentaz-zCORRECTzANSWER-detailzthezumbilicalzcord
AzdecreasezofzbloodzflowzandzO2zdeliveryztozfetusz&zincreaseszCO2zlevelzinzfetus.
Transientzcordzcompressionzcanzbezcommonzinzlabor.zVariablezFHRzdecel'sziszfrequentlyzassociatedzwithzco
rdzcompression.z-zCORRECTzANSWER-Definezcordzcompression.
Mayzleadztozhypoxemiazandzfetalzacidemia.zThezdepthzofzvariablezdeceleration'szisznotzenoughztozdetermi
nezdegree.zEvaluatezoxygenationzthroughzbaselinezheartzratezcharacteristicszthroughzrate,zvariabilityzandz
presencezorzabsencezofzaccelerations.z-zCORRECTzANSWER-
Explainzpersistentzorzrecurrentzcordzcompressionzconcernszandzwhatztozlookzat.
Aznormalzpartzofzlabor.zAszcontractionszbuildzincreasedzuterinezpressurezpreventszbloodzfromzentering/lea
vingzthezintervillouszspace.zDuringzthezpeakzthezfetuszrelieszcompletelyzonzitszoxygenzreservez(anzaerobiczc
hallengezthatzisznotzanzissuezforzazhealthzfetus.z-zCORRECTzANSWER-
Explainztransientzinterruptionszinzfetalzoxygenzsupplezduringzlabor.
, Chroniczdeficiencyzofzplacentazfunction,zusuallyzfromzanzinterruptionzofzoxygenationzpathwayzdueztozabru
ption,zmat.zhypozorzhypertensionzorzotherzissues.zInfantzisznotztolerantzofzcontractions.zCanzresultzinzfetalz
growzrestrictionsz(FGR)z-zCORRECTzANSWER-DefinezUteroplacentalzinsufficiencyz(UPI)
AssesszbaselinezFHR
Determinezrhythmsz(regularzvszirregular)
IDzaccelerationszandzdeceleration'szbutznotztheztypezofzdecelerationz(early/late/variable)
Thezfetalzheartbeatziszbestzheardzoverzthezfetalzback.z-zCORRECTzANSWER-
AuscultationzofzFetalzHeartzSoundsztellzyouzwhatzinformation?
Whereziszthezbestzplaceztozlisten?
Palpationztozdeterminezpresentationzandzpositionzofzthezfetuszandzaidzinzlocationzofzfetalzheartzsounds.
Head=hard,zround,zmovablezobject
Buttocks=softzandzirregularzshape
Back=smooth,zhardzsurfacezfeltzonzonezsidezofzthezabdomen
Irregularzknobszandzlumpszonzoppositezsidezofzabdomenzmayzbezhands,zfeet,zelbows,zandzkneesz-
zCORRECTzANSWER-Leopold'szManeuvers
Useszsonarztoztrackzthezfetalzmyocardiumz&zconvertszmovementzintozsound.zIfzplacedzincorrectlyzmayzpick
zupzmaternalzheart.z
PerformzLeopold'szmaneuversztozfindzfetalzback,zlocatezheartbeat,zcountzFHR,zcheckzmotherszpulsezandzco
mpare.z-zCORRECTzANSWER-HandheldzFetalzDoppler
IDzriskzfactorszsuchzaszHTNz(=vasoconstriction),zMaternalzsmoking,zabruption,zpost-
termzpregnancy,zmaternalzdiabeteszandzconsiderzFHRzcharacteristicsz-zCORRECTzANSWER-
Howzcanzyouzdeterminezifzthezplacentaziszfunctioningzoptimally?
500-700mlztozthezuteruszperzminute,z80%ziszdirectedztozthezplacentaz-zCORRECTzANSWER-
Howzmuchzbloodznormallyzflowsztozthezplacenta?
ThiszdependszonzoxygenationzwhichziszreflectedzinzFHRzvariabilityzandzaccelerationszonzthezfetalzmonitorzt
racings.z-zCORRECTzANSWER-Howzmanyzuterinezcontractionszcanzbeztolerated?
a)zFrequency
b)zDurationz-zCORRECTzANSWER-
Whichzcontractionzcharacteristicszcanzbezassessedzwithzaztocodynamometer?
a)zFrequency
b)zDuration
c)zIntensity
Uterusz-zCORRECTzANSWER-
AllzFetuseszofzmotherszinzlaborzexperiencezanzinterruptionzofzthezoxygenationzpathwayzatzwhichzpoint?
a)zThroughoutzlaborzandzdeliveryzunlesszthezusezofzazmorezaccuratezmethodziszclearlyzindicatedz-
zCORRECTzANSWER-ThezFHRzcanzbezmonitoredzusingzdopplerzultrasound?
a)zThroughoutzlaborzandzdeliveryzunlesszthezusezofzazmorezaccuratezmethodziszclearlyzindicated
b)zInternally
c)zOnlyzearlyzinzlabor
d)zThezFHRzcannotzbezmonitoredzbyzdopplerzultrasound
b)z110-160zbpmz-zCORRECTzANSWER-WhatzisztheznormalzrangezforzFHRzbasezlinezinzaztermzinfant?
a)z80-120zbpm
b)z110-160zbpm
c)z140-180bpm
d)zitzdependszonzthezsexzofzthezfetus
Mother'szinhalationztozlungsztozmat.zcirculatoryzsystemztozhemoglobinzinzRBC'sztozbloodstreamzinzuterus.z
Uterusztozspiralzarteriesztozplacentaztozintervillouszspaceztoztravelzviazsimplezdiffusionzintozthezvilli.zThezca
pillariesztozthezumb.zveinztozthezfetus.
Thezumb.zarteryzsendszwastez(CO2)ztozthezintervillouszspaceztozthezmotherszvenouszsystem.z-
zCORRECTzANSWER-Tracezthezflowzofzoxygenzfromzmotherztozfetuszandzback.
,1.zMotherz(bloodzplasma,zcardiaczoutput,zhemoglobinzconcentrationz&zO2zsaturation)
2.zPlacenta/intervillouszspacez(uterinezcontractionsz&zcalcification's)
3.zFetusz(vagalzresponsezakazdecelzorzcordzcompression)z-zCORRECTzANSWER-
Whatzfactorszimpactzmaternalzoxygenzdelivery?
30-50%
lateralzrecumbentzorzsemi-Fowler'sz-zCORRECTzANSWER-
Byzwhatz%zdoeszmaternalzcardiaczoutputzincreasezaboveztheznon-
pregnantzstatezandzwhatzpositionzhelpszthiszuteroplacentalzbloodzflow?
>5zcontractionszinz10zminz(morezfrequentlyzthanzQz2zmin)zaveragedzoverz30zminzwindow.
Causedzbyzoxytocin,zaminoinfusionzorzinzrarezcaseszspontaneously.z-zCORRECTzANSWER-
Defineztachysystolezcontractionszandzthezcausezof.
Maintainingzmat.zvolume,zmat.zpositioning,zintravenouszhydration.zDecreasingzmat.zpain/anxiety.
1.zRepositionzptztozside.
2.zAdminzIVzfluidzbolus.
3.zAdminz0.25mgzterbutalinezSQ.
4.zAdminzO2z10Lzviaznonzrebreatherzfacezmask.z-zCORRECTzANSWER-
Listzinterventionszforztachysystolezcontractions.
higherzconc.ztozlowerzconcentration.
1.Oxygenzfromzmaternalz(higher)ztozfetalzcompartmentz(lower)ztozfetalzhgbzthenztransportedztozfetalztissu
e.
2.zCO2zreturnsztozintervillouszspacezbyzpassivezdiffusionzandziszremovedzbyzthezmat.zvenouszsystem.z-
zCORRECTzANSWER-Describezpassivezdiffusionzaszrelatedztozthezmaternalzplacentalzfetalzsystem.
Placezherzinzlateralzposition,z&zincreasezIVzfluids.zIfznozimprovementzmayzneedztozgivezepiztozincreasezvasc
ularztone.z-zCORRECTzANSWER-
Maternalzhypotensionziszazpotentialzsidezeffectzofzregionalzanesthesiazandzanalgesia.zWhatznursingzinterv
entionszcouldzyouzuseztozraisezthezclient'szbloodzpressure?zChoosezallzthatzapply.
,A)zPlacezthezwomanzinzazsupinezposition.
B)zPlacezthezwomanzinzazlateralzposition.
C)zIncreasezintravenousz(IV)zfluids.
D)zContinuouszFetalzMonitor
E)zAdministerzephedrinezperzMDzorder
systoliczBPz>=z140mmzhg,zazdiastoliczBP>=z90zmmzhgzorzMAPzofz>=105z-zCORRECTzANSWER-
Definezmaternalzhypertensionz(gestational).
17g/dl,zfetalzhgbzhaszazhigherzoxygenzaffinityzthanzanzadultztozdevelopzinzanzoxygenzpoorzenvironment.zTh
ezfetalzcirculatoryzpatternzensureszbloodzwithzhigherzO2zandznutritionzcontentziszdeliveredztozthezvitalzorg
ansz(brainzandzheart)ztoztoleratezthezstresszofzlabor.z-zCORRECTzANSWER-
WhatzisztheznormalzexpectedzvaluezforzaztermzfetalzHGB?
1zvein,z2zarterieszencasedzinzwharton'szjelly.
O2z(highzcontent)ztravelszviazthezvein
CO2ztravelszviaz2zarterieszbackztozplacentaz-zCORRECTzANSWER-detailzthezumbilicalzcord
AzdecreasezofzbloodzflowzandzO2zdeliveryztozfetusz&zincreaseszCO2zlevelzinzfetus.
Transientzcordzcompressionzcanzbezcommonzinzlabor.zVariablezFHRzdecel'sziszfrequentlyzassociatedzwithzco
rdzcompression.z-zCORRECTzANSWER-Definezcordzcompression.
Mayzleadztozhypoxemiazandzfetalzacidemia.zThezdepthzofzvariablezdeceleration'szisznotzenoughztozdetermi
nezdegree.zEvaluatezoxygenationzthroughzbaselinezheartzratezcharacteristicszthroughzrate,zvariabilityzandz
presencezorzabsencezofzaccelerations.z-zCORRECTzANSWER-
Explainzpersistentzorzrecurrentzcordzcompressionzconcernszandzwhatztozlookzat.
Aznormalzpartzofzlabor.zAszcontractionszbuildzincreasedzuterinezpressurezpreventszbloodzfromzentering/lea
vingzthezintervillouszspace.zDuringzthezpeakzthezfetuszrelieszcompletelyzonzitszoxygenzreservez(anzaerobiczc
hallengezthatzisznotzanzissuezforzazhealthzfetus.z-zCORRECTzANSWER-
Explainztransientzinterruptionszinzfetalzoxygenzsupplezduringzlabor.
, Chroniczdeficiencyzofzplacentazfunction,zusuallyzfromzanzinterruptionzofzoxygenationzpathwayzdueztozabru
ption,zmat.zhypozorzhypertensionzorzotherzissues.zInfantzisznotztolerantzofzcontractions.zCanzresultzinzfetalz
growzrestrictionsz(FGR)z-zCORRECTzANSWER-DefinezUteroplacentalzinsufficiencyz(UPI)
AssesszbaselinezFHR
Determinezrhythmsz(regularzvszirregular)
IDzaccelerationszandzdeceleration'szbutznotztheztypezofzdecelerationz(early/late/variable)
Thezfetalzheartbeatziszbestzheardzoverzthezfetalzback.z-zCORRECTzANSWER-
AuscultationzofzFetalzHeartzSoundsztellzyouzwhatzinformation?
Whereziszthezbestzplaceztozlisten?
Palpationztozdeterminezpresentationzandzpositionzofzthezfetuszandzaidzinzlocationzofzfetalzheartzsounds.
Head=hard,zround,zmovablezobject
Buttocks=softzandzirregularzshape
Back=smooth,zhardzsurfacezfeltzonzonezsidezofzthezabdomen
Irregularzknobszandzlumpszonzoppositezsidezofzabdomenzmayzbezhands,zfeet,zelbows,zandzkneesz-
zCORRECTzANSWER-Leopold'szManeuvers
Useszsonarztoztrackzthezfetalzmyocardiumz&zconvertszmovementzintozsound.zIfzplacedzincorrectlyzmayzpick
zupzmaternalzheart.z
PerformzLeopold'szmaneuversztozfindzfetalzback,zlocatezheartbeat,zcountzFHR,zcheckzmotherszpulsezandzco
mpare.z-zCORRECTzANSWER-HandheldzFetalzDoppler
IDzriskzfactorszsuchzaszHTNz(=vasoconstriction),zMaternalzsmoking,zabruption,zpost-
termzpregnancy,zmaternalzdiabeteszandzconsiderzFHRzcharacteristicsz-zCORRECTzANSWER-
Howzcanzyouzdeterminezifzthezplacentaziszfunctioningzoptimally?
500-700mlztozthezuteruszperzminute,z80%ziszdirectedztozthezplacentaz-zCORRECTzANSWER-
Howzmuchzbloodznormallyzflowsztozthezplacenta?
ThiszdependszonzoxygenationzwhichziszreflectedzinzFHRzvariabilityzandzaccelerationszonzthezfetalzmonitorzt
racings.z-zCORRECTzANSWER-Howzmanyzuterinezcontractionszcanzbeztolerated?
