CEFM Exam UPDATED ACTUAL Exam
Questions and CORRECT Answers
what is an amnioinfusion? - CORRECT ANSWER - a transvaginal infusion of room
temperature isotonic fluid (normal saline or lactated ringers) by gravity of infusion pump to
compensate for the loss of amniotic fluid
what are indications for an amnioinfusion? - CORRECT ANSWER - - laboring preterm
women with PPROM
- variable deceleration uncorrectable with conventional interventions
- significant oligohydramnios (AFI < or equal to 5) at term when labor is being induced
how is an amnioinfusion run? - CORRECT ANSWER - bolus of 250 to 500 mL over 20 to
30 minutes followed by 2-3 mL per minute (max 180 mL per hr)
how do you monitor an amnioinfusion? - CORRECT ANSWER - assess output to avoid
over distension of uterus (weigh pads / count # of pads)
assess uterine resting tone (should not exceed 40mmHg)
how will the resting tone of the uterus appear with an amnioinfusion? - CORRECT
ANSWER - uterine resting tone will appear higher than normal from 25-40mmHg)
true resting tone can be checked periodically by temporarily discontinuing infusion Q30-60min
what is the goal of intrauterine resuscitation measures in response to category II or III tracings? -
CORRECT ANSWER - to promote fetal oxygenation
what are some techniques or measures in response to category II or III tracings? - CORRECT
ANSWER - - lateral positioning (left or right)
- IV fluid bolus of LR
,- O2 administration at 10 L/mine via nonrebreather (discontinue ASAP based on fetal status)
- modify pushing efforts (every other contraction, every third contraction, or discontinue
pushing)
- decrease in pitocin rate, discontinue pitocin, remove cervidil, or withhold misprostol
what is the goal of intrauterine resuscitation measures in response to tachysystole? - CORRECT
ANSWER - to reduce uterine activity
what are some techniques or measures in response to tachysystole? - CORRECT
ANSWER - - lateral positioning (left or right0
- IV fluid bolus of LR
- decrease in pitocin rate, discontinue pitocin, remove cervidil, or withhold misprostol
- if no response, terbutaline 0.25 mg SQ may be considered
what is the goal of intrauterine resuscitation measures in response to recurrent variable
decelerations? - CORRECT ANSWER - to alleviate umbilical cord compression
what are some techniques or measures in response to recurrent variable decelerations? -
CORRECT ANSWER - - repositioning
- amnioinfusion (during first stage of later)
- modify pushing efforts (every other contraction, every third contraction, or discontinue
pushing)
what is the goal of intrauterine resuscitation measures in response to maternal hypotension? -
CORRECT ANSWER - to correct maternal hypotension
what are some techniques or measures in response to maternal hypotension? - CORRECT
ANSWER - - lateral positioning (either left or right)
- IV fluid bolus of LR
- if no response, ephedrine 5 mg to 10 mg IV push may be considered
, how often should you chart on EFM strips in the first stage of labor? - CORRECT
ANSWER - - pregnancy without complications: Q30 minutes
- pregnancy with complications: Q15 minutes
how often should you chart of EFM strips in the second stage of labor? - CORRECT
ANSWER - - pregnancy without complications: Q15 minutes
- pregnancy with complications: Q5 minutes
fetal heart rate patterns are defined as... - CORRECT ANSWER - baseline, periodic, or
episodic
what are periodic patterns? - CORRECT ANSWER - those that are associated with uterine
contractions
what are episodic patterns? - CORRECT ANSWER - those that are associated with uterine
contractions
why should there be no differentiation between short and long-term variability? - CORRECT
ANSWER - in practice, they are visually determine das unit
a complete description of the EFM tracing includes... - CORRECT ANSWER - uterine
contractions, baseline fetal heart rate, baseline variability, presence of accelerations, periodic or
episodic deceleration, and changes or trends of the fetal heart rate pattern over time
what are some factors that can cause accelerations in FHR? - CORRECT ANSWER --
spontaneous fetal movement
- scalp or vibroacoustic stimulation
- vaginal examination
Questions and CORRECT Answers
what is an amnioinfusion? - CORRECT ANSWER - a transvaginal infusion of room
temperature isotonic fluid (normal saline or lactated ringers) by gravity of infusion pump to
compensate for the loss of amniotic fluid
what are indications for an amnioinfusion? - CORRECT ANSWER - - laboring preterm
women with PPROM
- variable deceleration uncorrectable with conventional interventions
- significant oligohydramnios (AFI < or equal to 5) at term when labor is being induced
how is an amnioinfusion run? - CORRECT ANSWER - bolus of 250 to 500 mL over 20 to
30 minutes followed by 2-3 mL per minute (max 180 mL per hr)
how do you monitor an amnioinfusion? - CORRECT ANSWER - assess output to avoid
over distension of uterus (weigh pads / count # of pads)
assess uterine resting tone (should not exceed 40mmHg)
how will the resting tone of the uterus appear with an amnioinfusion? - CORRECT
ANSWER - uterine resting tone will appear higher than normal from 25-40mmHg)
true resting tone can be checked periodically by temporarily discontinuing infusion Q30-60min
what is the goal of intrauterine resuscitation measures in response to category II or III tracings? -
CORRECT ANSWER - to promote fetal oxygenation
what are some techniques or measures in response to category II or III tracings? - CORRECT
ANSWER - - lateral positioning (left or right)
- IV fluid bolus of LR
,- O2 administration at 10 L/mine via nonrebreather (discontinue ASAP based on fetal status)
- modify pushing efforts (every other contraction, every third contraction, or discontinue
pushing)
- decrease in pitocin rate, discontinue pitocin, remove cervidil, or withhold misprostol
what is the goal of intrauterine resuscitation measures in response to tachysystole? - CORRECT
ANSWER - to reduce uterine activity
what are some techniques or measures in response to tachysystole? - CORRECT
ANSWER - - lateral positioning (left or right0
- IV fluid bolus of LR
- decrease in pitocin rate, discontinue pitocin, remove cervidil, or withhold misprostol
- if no response, terbutaline 0.25 mg SQ may be considered
what is the goal of intrauterine resuscitation measures in response to recurrent variable
decelerations? - CORRECT ANSWER - to alleviate umbilical cord compression
what are some techniques or measures in response to recurrent variable decelerations? -
CORRECT ANSWER - - repositioning
- amnioinfusion (during first stage of later)
- modify pushing efforts (every other contraction, every third contraction, or discontinue
pushing)
what is the goal of intrauterine resuscitation measures in response to maternal hypotension? -
CORRECT ANSWER - to correct maternal hypotension
what are some techniques or measures in response to maternal hypotension? - CORRECT
ANSWER - - lateral positioning (either left or right)
- IV fluid bolus of LR
- if no response, ephedrine 5 mg to 10 mg IV push may be considered
, how often should you chart on EFM strips in the first stage of labor? - CORRECT
ANSWER - - pregnancy without complications: Q30 minutes
- pregnancy with complications: Q15 minutes
how often should you chart of EFM strips in the second stage of labor? - CORRECT
ANSWER - - pregnancy without complications: Q15 minutes
- pregnancy with complications: Q5 minutes
fetal heart rate patterns are defined as... - CORRECT ANSWER - baseline, periodic, or
episodic
what are periodic patterns? - CORRECT ANSWER - those that are associated with uterine
contractions
what are episodic patterns? - CORRECT ANSWER - those that are associated with uterine
contractions
why should there be no differentiation between short and long-term variability? - CORRECT
ANSWER - in practice, they are visually determine das unit
a complete description of the EFM tracing includes... - CORRECT ANSWER - uterine
contractions, baseline fetal heart rate, baseline variability, presence of accelerations, periodic or
episodic deceleration, and changes or trends of the fetal heart rate pattern over time
what are some factors that can cause accelerations in FHR? - CORRECT ANSWER --
spontaneous fetal movement
- scalp or vibroacoustic stimulation
- vaginal examination
