Fetal monitoring Exam Questions
Complete Solutions New Update
What the is purpose of fetal monitoring? - Answers -✔✔ 1. Evaluate the effects of
intrapartum events on the fetus
2. Evaluate uterine contractions
Assessment of the _____ is an indirect measure of fetal oxygenation. - Answers -✔✔
FHR
What helps to minimize the risk of errors and avoid miscommunication during electronic
fetal heart monitoring? - Answers -✔✔ The use of standardized language
Describe the overall function of the ultrasound transducer. - Answers -✔✔ The
ultrasound transducer reflects sound waves off fetal heart valves. These waves hit one
of 4 events (Mitral/Aortic) during systole. Reflected sound waves return towards the
transducer. Several heartbeats are averaged which then produce an electronic reading
on a screen. This is not an exact science.
Describe the two different transducers present on an external fetal monitor. - Answers -
✔✔ One transducer, aka. the "toco," is gray with a button that depresses. This
transducer is placed on the anterior abdomen and is used for sensing uterine
contractions. The other transducer is blue and is actually an ultrasound probe. This
transducer is placed on the lateral portion of the abdomen and is used for sensing fetal
heart rate.
In what situations might an internal scalp electrode be utilized? - Answers -✔✔ 1.
Maternal morbid obesity
2. High risk fetus
True or false: The use of internal electrodes do not increase infection risks. - Answers -
✔✔ False - internal electrodes do increase the risk of infection and are not preferred
What criteria must be met before an internal scalp electrode can be used? - Answers -
✔✔ 1. Cervix must be 1 cm dilated
2. Water sac must be ruptured
What are abnormal fetal heart rate tracings predictive of? - Answers -✔✔ Fetal acid-
base abnormalities
What do category III FHR tracings include? - Answers -✔✔ 1. Absent baseline FHR
variability AND any of the following:
- Recurrent late decelerations
, - Recurrent variable decelerations
- Bradycardia
2. Sinusoidal Pattern
Provide interventions for treatment of category III FHR tracings. - Answers -✔✔ -
Maternal oxygen administration
- Change in maternal position
- IV Fluids
- Discontinuation of labor stimulation
- Treatment of maternal hypotension
- Consideration of cesarean delivery
What is the goal and associated interventions for the following FHR abnormalities:
- Recurrent late decelerations
- Prolonged decelerations or bradycardia
- Minimal or absent variability - Answers -✔✔ Goal: Promote fetal oxygenation and
improve uteroplacental blood flow
Interventions:
- Lateral positioning
- Maternal Oxygen administration
- IV Fluid bolus
- Reduce uterine contraction frequency (d/c pitocin)
What is the goal and associated interventions for tachysystole? - Answers -✔✔ Goal:
Reduce uterine activity
Interventions:
- D/C pitocin or cervical ripening agents
- Administer tocolytic medication (ex. terbutaline)
- IV hydration
What is the goal and associated interventions for the following FHR abnormalities:
- Recurrent variable decelerations
- Prolonged decelerations
- Bradycardia - Answers -✔✔ Goal: Alleviate umbilical cord compression
Interventions:
- Maternal repositioning
- Amnioinfusion
- If prolapsed cord, elevate fetal head and prepare for c-section
How does an internal fetal monitor determine FHR? - Answers -✔✔ The fetal "R" wave
of the QRS complex initiates counting by the cardiotachometer. Rate is counted based
on R-R intervals.
What information does a tocodynamometer report? What information can it not provide?
- Answers -✔✔ Provides frequency and duration of contractions, but NOT quantitative
data on intensity/strength of contractions
Complete Solutions New Update
What the is purpose of fetal monitoring? - Answers -✔✔ 1. Evaluate the effects of
intrapartum events on the fetus
2. Evaluate uterine contractions
Assessment of the _____ is an indirect measure of fetal oxygenation. - Answers -✔✔
FHR
What helps to minimize the risk of errors and avoid miscommunication during electronic
fetal heart monitoring? - Answers -✔✔ The use of standardized language
Describe the overall function of the ultrasound transducer. - Answers -✔✔ The
ultrasound transducer reflects sound waves off fetal heart valves. These waves hit one
of 4 events (Mitral/Aortic) during systole. Reflected sound waves return towards the
transducer. Several heartbeats are averaged which then produce an electronic reading
on a screen. This is not an exact science.
Describe the two different transducers present on an external fetal monitor. - Answers -
✔✔ One transducer, aka. the "toco," is gray with a button that depresses. This
transducer is placed on the anterior abdomen and is used for sensing uterine
contractions. The other transducer is blue and is actually an ultrasound probe. This
transducer is placed on the lateral portion of the abdomen and is used for sensing fetal
heart rate.
In what situations might an internal scalp electrode be utilized? - Answers -✔✔ 1.
Maternal morbid obesity
2. High risk fetus
True or false: The use of internal electrodes do not increase infection risks. - Answers -
✔✔ False - internal electrodes do increase the risk of infection and are not preferred
What criteria must be met before an internal scalp electrode can be used? - Answers -
✔✔ 1. Cervix must be 1 cm dilated
2. Water sac must be ruptured
What are abnormal fetal heart rate tracings predictive of? - Answers -✔✔ Fetal acid-
base abnormalities
What do category III FHR tracings include? - Answers -✔✔ 1. Absent baseline FHR
variability AND any of the following:
- Recurrent late decelerations
, - Recurrent variable decelerations
- Bradycardia
2. Sinusoidal Pattern
Provide interventions for treatment of category III FHR tracings. - Answers -✔✔ -
Maternal oxygen administration
- Change in maternal position
- IV Fluids
- Discontinuation of labor stimulation
- Treatment of maternal hypotension
- Consideration of cesarean delivery
What is the goal and associated interventions for the following FHR abnormalities:
- Recurrent late decelerations
- Prolonged decelerations or bradycardia
- Minimal or absent variability - Answers -✔✔ Goal: Promote fetal oxygenation and
improve uteroplacental blood flow
Interventions:
- Lateral positioning
- Maternal Oxygen administration
- IV Fluid bolus
- Reduce uterine contraction frequency (d/c pitocin)
What is the goal and associated interventions for tachysystole? - Answers -✔✔ Goal:
Reduce uterine activity
Interventions:
- D/C pitocin or cervical ripening agents
- Administer tocolytic medication (ex. terbutaline)
- IV hydration
What is the goal and associated interventions for the following FHR abnormalities:
- Recurrent variable decelerations
- Prolonged decelerations
- Bradycardia - Answers -✔✔ Goal: Alleviate umbilical cord compression
Interventions:
- Maternal repositioning
- Amnioinfusion
- If prolapsed cord, elevate fetal head and prepare for c-section
How does an internal fetal monitor determine FHR? - Answers -✔✔ The fetal "R" wave
of the QRS complex initiates counting by the cardiotachometer. Rate is counted based
on R-R intervals.
What information does a tocodynamometer report? What information can it not provide?
- Answers -✔✔ Provides frequency and duration of contractions, but NOT quantitative
data on intensity/strength of contractions
