AWHONN Advanced FHM Course
Exam Answers
A girl turned into delivered by means of cesarean at 1211 and thick meconium changed into
cited. Apgar rankings were 4/five/7 at 1/five/10. Arterial umbilical wire fuel consequences are:
pH 7.26/pCO2 fifty six.5/pO2 23/BE -19. The new child had a regular sinus rhythm, ordinary
ECG, and echocardiogram and turned into discharged to home with mother. What is the
maximum viable reason behind the neonate's normal sinus rhythm at birth? - ANS-The supply of
the ectopic fetal cardiac stimulation had resolved
At 1410, the nurse once more telephoned the provider to record Silvia's status, together with
two extra darkish purple blood clots and absent variability with recurrent decelerations, and
requested the issuer to return to the bedside for evaluation. The provider indicated she changed
into "on the manner to the health center" and ordered an emergency cesarean to be started by
using the senior resident. Silvia changed into prepped for cesarean start. The nurse is making
plans to report her smartphone report to the attending physician. Given the emergent scenario,
the quality method to documentation would be: - ANS-Continue presenting take care of Silvia
and write a past due entry summarizing the conversation after the cesarean is completed
CASE STUDY A) SILVIA. Silvia, a 28-yr-vintage G1P0000 at 39 1/7 weeks by sonogram, and
her companion arrived on the hard work unit at 0730 for scheduled induction for IUGR/FGR.
Silvia's circle of relatives records is terrible for scientific troubles apart from her mom's
lengthy-term history of diabetes. Silvia has no records of scientific issues and he or she has by
no means had any surgeries. She evolved gestational diabetes with this pregnancy, however
her different prenatal labs had been all ordinary. During one of the ultrasound examinations
executed to evaluate the IUGR/FGR, a single umbilical artery become noted. On her maximum
current biophysical profile (BPP), the amniotic fluid index (AFI) become eleven cm (AFI less
than 5 cm is defined as oligohydramnios) and the predicted fetal weight (EFW) became 2524
grams (7th percentile). WHAT FETAL HEART RATE DECELERATION IS MORE LIKELY TO
OCCUR IN THE PRESENCE OF SILVIA'S SINGLE UMBILICAL ARTERY? - ANS-Variable
decelerations
CASE STUDY B) NELL. Nell, a 24-12 months-old G3 P020 at 42&three weeks arrived on L&D
for a night IOL for post-dates. Nell has had an exploratory lap. To do away with scar tissue on
her L ovary and intestines and has had infrequent menstrual cycles. She had has 2 SABs - at
12 and 5 weeks. Prenatal labs were WDL. Her thyroid is enlarged; but, her TSH, T4, and T3 had
been achieved at 39 weeks and were WDL. Nell has a circle of relatives history of HTN. An US
at 19 weeks discovered a low-mendacity placenta that resolved by 37 5/7 weeks. Today in
triage, an US discovered an EFW of 3300g and an AFI of 3 cm. Nell has had reactive NSTs.
Admission important signs and symptoms were WDL. SVE findings: fingertip, 40%, and -2
station. Membranes intact and cephalic presentation. Nell denied feeling everyday cramping.
, Category I tracing. A vaginal prostaglandin insert become placed. WHICH COMPROMISE IN
FETAL OXYGENATION COULD BE A RESULT OF A POST-DATE PREGNANCY? -
ANS-Decreased placental perfusion
CASE STUDY C) HELEN. Helen, a 23 12 months-vintage G3 P0020 at 25&6 involves L&D with
a primary grievance of "backache and cramping". Helen is a thin, young female and her prenatal
document indicates she changed into born upfront. She's had 2 SABs and a couple of
uterine/vaginal infections, along with treatment for dysplasia with a LEEP system. She
commenced prenatal care at 16 weeks and attended 2 appointments because of transportation
issues. Following a swab of the fluid in her vagina, which turned into terrible for ferning, SVE
findings were 2/70/-3, cephalic presentation. Helen denies current sexual sex. States her toddler
is lively these days. FHR is auscultated at 156 bpm and outside EFM components are
positioned. Demographic, obstetric, and socioeconomic factors offer important records to permit
individualized intrapartum care making plans. BASED ON STATISTICAL REPORTS AND
CURRENT PUBLISHED LITERATURE, BLACK WOMEN HAVE A HIGHER INCIDENCE OF: -
ANS-Preterm beginning
CASE STUDY D) MICHELLE. Michelle is a 31-yr-antique G1P0 at 38&6 who arrives to triage
conserving her stomach while moaning in pain. Michelle reports a history of regular BP for the
duration of this pregnancy and opioid use disease. Abdominal ache started out 12 hours ago
and has expanded in depth. Michelle has had unfastened stools and saved down water and
electrolyte beverages all day but maintains to have the urge to have a bowel motion. Vital
symptoms: T 97F (36.6C), BP a hundred sixty five/a hundred and five, HR a hundred, RR 23.
The nurse uses a doppler for intermittent auscultation at some point of the assessment,
auscultating a normal fetal coronary heart charge rhythm within a everyday baseline variety.
Michelle reports fetal motion. The nurse palpates Michelle's abdomen as intermittently sturdy
contractions with intervals of comfortable tone. Michelle reviews greater ache in right top
quadrant. WHICH MICHELLE'S PRESENTING HISTORY, WHAT IS THE NURSE'S FIRST
PRIORITY CARE? - ANS-Reassess Michelle's blood pressure using the perfect sized blood
stress cuff
Clinical decision-making on the bedside ought to encompass: - ANS-Integration of physiologic
principles with maternal-fetal evaluation findings
Fetal hydrops may additionally present on ultrasound as fetal scalp edema and accelerated
belly fluid as a result of which fetal situation? - ANS-Congestive coronary heart failure
Helen's nurse makes use of the SBAR framework for communicating patient records to
colleagues. What do the letters SBAR stand for? - ANS-S-situation B-heritage A-evaluation
R-advice
How ought to a fetal arrhythmia have an effect on fetal oxygenation? - ANS-By lowering fetal
perfusion
Exam Answers
A girl turned into delivered by means of cesarean at 1211 and thick meconium changed into
cited. Apgar rankings were 4/five/7 at 1/five/10. Arterial umbilical wire fuel consequences are:
pH 7.26/pCO2 fifty six.5/pO2 23/BE -19. The new child had a regular sinus rhythm, ordinary
ECG, and echocardiogram and turned into discharged to home with mother. What is the
maximum viable reason behind the neonate's normal sinus rhythm at birth? - ANS-The supply of
the ectopic fetal cardiac stimulation had resolved
At 1410, the nurse once more telephoned the provider to record Silvia's status, together with
two extra darkish purple blood clots and absent variability with recurrent decelerations, and
requested the issuer to return to the bedside for evaluation. The provider indicated she changed
into "on the manner to the health center" and ordered an emergency cesarean to be started by
using the senior resident. Silvia changed into prepped for cesarean start. The nurse is making
plans to report her smartphone report to the attending physician. Given the emergent scenario,
the quality method to documentation would be: - ANS-Continue presenting take care of Silvia
and write a past due entry summarizing the conversation after the cesarean is completed
CASE STUDY A) SILVIA. Silvia, a 28-yr-vintage G1P0000 at 39 1/7 weeks by sonogram, and
her companion arrived on the hard work unit at 0730 for scheduled induction for IUGR/FGR.
Silvia's circle of relatives records is terrible for scientific troubles apart from her mom's
lengthy-term history of diabetes. Silvia has no records of scientific issues and he or she has by
no means had any surgeries. She evolved gestational diabetes with this pregnancy, however
her different prenatal labs had been all ordinary. During one of the ultrasound examinations
executed to evaluate the IUGR/FGR, a single umbilical artery become noted. On her maximum
current biophysical profile (BPP), the amniotic fluid index (AFI) become eleven cm (AFI less
than 5 cm is defined as oligohydramnios) and the predicted fetal weight (EFW) became 2524
grams (7th percentile). WHAT FETAL HEART RATE DECELERATION IS MORE LIKELY TO
OCCUR IN THE PRESENCE OF SILVIA'S SINGLE UMBILICAL ARTERY? - ANS-Variable
decelerations
CASE STUDY B) NELL. Nell, a 24-12 months-old G3 P020 at 42&three weeks arrived on L&D
for a night IOL for post-dates. Nell has had an exploratory lap. To do away with scar tissue on
her L ovary and intestines and has had infrequent menstrual cycles. She had has 2 SABs - at
12 and 5 weeks. Prenatal labs were WDL. Her thyroid is enlarged; but, her TSH, T4, and T3 had
been achieved at 39 weeks and were WDL. Nell has a circle of relatives history of HTN. An US
at 19 weeks discovered a low-mendacity placenta that resolved by 37 5/7 weeks. Today in
triage, an US discovered an EFW of 3300g and an AFI of 3 cm. Nell has had reactive NSTs.
Admission important signs and symptoms were WDL. SVE findings: fingertip, 40%, and -2
station. Membranes intact and cephalic presentation. Nell denied feeling everyday cramping.
, Category I tracing. A vaginal prostaglandin insert become placed. WHICH COMPROMISE IN
FETAL OXYGENATION COULD BE A RESULT OF A POST-DATE PREGNANCY? -
ANS-Decreased placental perfusion
CASE STUDY C) HELEN. Helen, a 23 12 months-vintage G3 P0020 at 25&6 involves L&D with
a primary grievance of "backache and cramping". Helen is a thin, young female and her prenatal
document indicates she changed into born upfront. She's had 2 SABs and a couple of
uterine/vaginal infections, along with treatment for dysplasia with a LEEP system. She
commenced prenatal care at 16 weeks and attended 2 appointments because of transportation
issues. Following a swab of the fluid in her vagina, which turned into terrible for ferning, SVE
findings were 2/70/-3, cephalic presentation. Helen denies current sexual sex. States her toddler
is lively these days. FHR is auscultated at 156 bpm and outside EFM components are
positioned. Demographic, obstetric, and socioeconomic factors offer important records to permit
individualized intrapartum care making plans. BASED ON STATISTICAL REPORTS AND
CURRENT PUBLISHED LITERATURE, BLACK WOMEN HAVE A HIGHER INCIDENCE OF: -
ANS-Preterm beginning
CASE STUDY D) MICHELLE. Michelle is a 31-yr-antique G1P0 at 38&6 who arrives to triage
conserving her stomach while moaning in pain. Michelle reports a history of regular BP for the
duration of this pregnancy and opioid use disease. Abdominal ache started out 12 hours ago
and has expanded in depth. Michelle has had unfastened stools and saved down water and
electrolyte beverages all day but maintains to have the urge to have a bowel motion. Vital
symptoms: T 97F (36.6C), BP a hundred sixty five/a hundred and five, HR a hundred, RR 23.
The nurse uses a doppler for intermittent auscultation at some point of the assessment,
auscultating a normal fetal coronary heart charge rhythm within a everyday baseline variety.
Michelle reports fetal motion. The nurse palpates Michelle's abdomen as intermittently sturdy
contractions with intervals of comfortable tone. Michelle reviews greater ache in right top
quadrant. WHICH MICHELLE'S PRESENTING HISTORY, WHAT IS THE NURSE'S FIRST
PRIORITY CARE? - ANS-Reassess Michelle's blood pressure using the perfect sized blood
stress cuff
Clinical decision-making on the bedside ought to encompass: - ANS-Integration of physiologic
principles with maternal-fetal evaluation findings
Fetal hydrops may additionally present on ultrasound as fetal scalp edema and accelerated
belly fluid as a result of which fetal situation? - ANS-Congestive coronary heart failure
Helen's nurse makes use of the SBAR framework for communicating patient records to
colleagues. What do the letters SBAR stand for? - ANS-S-situation B-heritage A-evaluation
R-advice
How ought to a fetal arrhythmia have an effect on fetal oxygenation? - ANS-By lowering fetal
perfusion
