AWHONN's Advanced Fetal Heart Monitoring (FHM) Course Exam| Questions and Answers, 100% Correct| Updated 2024-2025
CASE STUDY A) SILVIA. Silvia, a 28-year-old G1P0000 at 39 1/7 weeks by
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 problems with the
exception of her mother's long-term history of diabetes. Silvia has no history of
medical problems and she has never had any surgeries. She developed gestational
diabetes with this pregnancy, but her other prenatal labs were all normal. During
one of the ultrasound examinations performed to evaluate the IUGR/FGR, a single
umbilical artery was noted. On her most recent biophysical profile (BPP), the
amniotic fluid 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). WHAT FETAL HEART RATE DECELERATION IS MORE
LIKELY TO OCCUR IN THE PRESENCE OF SILVIA'S SINGLE UMBILICAL
ARTERY?
Variable decelerations
The single umbilical artery impacts which component of the oxygen transfer
system?
Oxygen delivery
Which of Silvia's findings indicates a potential for chronic fetal hypoxemia?
Intrauterine growth restriction (IUGR)
With the finding of a single umbilical artery, what would you expect to occur with
fetal perfusion?
Decreased blood perfusion from the fetus to the placenta
Silvia's admission vital signs were BP 109/60, pulse 83 bpm, respirations
18/minute, temperature 97F (36.6C). Vaginal examination findings were 2-3 cm
dilated, 50% effaced, -1 station, membranes intact, and cephalic presentation.
External electronic fetal monitor devices were placed (ultrasound and
tocodynamometer). She denied having contractions, 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 5 mU/min. PRIMARY BENEFITS
ASSOCIATED WITH THE USE OF STANDARDIZED TERMINOLOGY FOR
FHM INTERPRETATION IN THE CLINICAL SETTING INCLUDE:
Enhanced communication among health care providers and promotion of patient
safety
Refer to tracing A-1. Which is the correct assessment of the admission tracing?
Moderate variability
Refer to tracing A-1. Based on this tracing, a necessary intervention would be to:
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