AWHONN Advanced FHM Course Exam
Answers
CASE STUDY A) SILVIA. Silvia, a 28-year-old G1P0000 at 39 1/7 weeks by
ER
sonogram, and her partner arrived on the labor unit at 0730 for scheduled
induction for IUGR/FGR. Silvia's family history is negative for medical
H
problems with the exception of her mother's long-term history of diabetes.
IG
Silvia has no history of medical problems and she has never had any
surgeries. She developed gestational diabetes with this pregnancy, but her
H
other prenatal labs were all normal. During one of the ultrasound
examinations performed to evaluate the IUGR/FGR, a single umbilical artery
G
was noted. On her most recent biophysical profile (BPP), the amniotic fluid
IN
index (AFI) was 11 cm (AFI less than 5 cm is defined as oligohydramnios)
and the estimated fetal weight (EFW) was 2524 grams (7th percentile).
Y
WHAT FETAL HEART RATE DECELERATION IS MORE LIKELY TO OCCUR
FL
IN THE PRESENCE OF SILVIA'S SINGLE UMBILICAL ARTERY? - ANS
Variable decelerations
The single umbilical artery impacts which component of the oxygen
transfer system? - ANS Oxygen delivery
, Which of Silvia's findings indicates a potential for chronic fetal hypoxemia?
- ANS Intrauterine growth restriction (IUGR)
With the finding of a single umbilical artery, what would you expect to
ER
occur with fetal perfusion? - ANS Decreased blood perfusion from the
fetus to the placenta
H
Silvia's admission vital signs were BP 109/60, pulse 83 bpm, respirations
IG
18/minute, temperature 97F (36.6C). Vaginal examination findings were 2-3
cm dilated, 50% effaced, -1 station, membranes intact, and cephalic
H
presentation. External electronic fetal monitor devices were placed
G
(ultrasound and tocodynamometer). She denied having contractions,
IN
vaginal leaking or bleeding. Following this admission tracing, oxytocin was
ordered and initiated at 2 mU/min. Within an hour, the rate was increased to
Y
5 mU/min. PRIMARY BENEFITS ASSOCIATED WITH THE USE OF
FL
STANDARDIZED TERMINOLOGY FOR FHM INTERPRETATION IN THE
CLINICAL SETTING INCLUDE: - ANS Enhanced communication among
health care providers and promotion of patient safety
Answers
CASE STUDY A) SILVIA. Silvia, a 28-year-old G1P0000 at 39 1/7 weeks by
ER
sonogram, and her partner arrived on the labor unit at 0730 for scheduled
induction for IUGR/FGR. Silvia's family history is negative for medical
H
problems with the exception of her mother's long-term history of diabetes.
IG
Silvia has no history of medical problems and she has never had any
surgeries. She developed gestational diabetes with this pregnancy, but her
H
other prenatal labs were all normal. During one of the ultrasound
examinations performed to evaluate the IUGR/FGR, a single umbilical artery
G
was noted. On her most recent biophysical profile (BPP), the amniotic fluid
IN
index (AFI) was 11 cm (AFI less than 5 cm is defined as oligohydramnios)
and the estimated fetal weight (EFW) was 2524 grams (7th percentile).
Y
WHAT FETAL HEART RATE DECELERATION IS MORE LIKELY TO OCCUR
FL
IN THE PRESENCE OF SILVIA'S SINGLE UMBILICAL ARTERY? - ANS
Variable decelerations
The single umbilical artery impacts which component of the oxygen
transfer system? - ANS Oxygen delivery
, Which of Silvia's findings indicates a potential for chronic fetal hypoxemia?
- ANS Intrauterine growth restriction (IUGR)
With the finding of a single umbilical artery, what would you expect to
ER
occur with fetal perfusion? - ANS Decreased blood perfusion from the
fetus to the placenta
H
Silvia's admission vital signs were BP 109/60, pulse 83 bpm, respirations
IG
18/minute, temperature 97F (36.6C). Vaginal examination findings were 2-3
cm dilated, 50% effaced, -1 station, membranes intact, and cephalic
H
presentation. External electronic fetal monitor devices were placed
G
(ultrasound and tocodynamometer). She denied having contractions,
IN
vaginal leaking or bleeding. Following this admission tracing, oxytocin was
ordered and initiated at 2 mU/min. Within an hour, the rate was increased to
Y
5 mU/min. PRIMARY BENEFITS ASSOCIATED WITH THE USE OF
FL
STANDARDIZED TERMINOLOGY FOR FHM INTERPRETATION IN THE
CLINICAL SETTING INCLUDE: - ANS Enhanced communication among
health care providers and promotion of patient safety
