FETAL HEART MONITORING RELIAS EXAM 2024 QUESTIONS AND ANSWERS
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FETAL HEART MONITORING RELIAS
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FETAL HEART MONITORING RELIAS
FETAL HEART MONITORING RELIAS EXAM 2024 QUESTIONS AND ANSWERS
Ms. Sato is an 18-year-old G1P0 who presents for an induction of labor. She is placed on the fetal monitor with an external tocodynamometer. Which of the following will the healthcare provider be able to assess using this method? Sel...
FETAL HEART MONITORING RELIAS
EXAM 2024 QUESTIONS AND ANSWERS
Ms. Sato is an 18-year-old G1P0 who presents for an induction of labor. She is
placed on the fetal monitor with an external tocodynamometer. Which of the
following will the healthcare provider be able to assess using this method? Select
all that apply.
a. Frequency of contractions
b. Duration of contractions
c. Strength of contractions
d. Resting tone between contractions
a and b
External uterine monitoring allows for the assessment of the frequency and duration of
contractions. The relative strength of the uterine contraction and resting uterine tone
between contractions require internal contraction monitoring.
Ms. Johnson is a 29-year-old G3P2. She has been admitted for premature rupture
of membranes at 38 weeks' gestation, following an uncomplicated pregnancy. Her
medical history includes asthma with frequent use of rescue inhalers. Ms.
Johnson is at risk of interruption at which points in the maternal-fetal oxygen
pathway?
Select 2 answers.
A Maternal inhalation
b Maternal circulation
c Placenta
d Uterus
e Umbilical cord
f Fetal circulation
A Maternal inhalation
e Umbilical cord
Due to her history of asthma and loss of amniotic fluid, there is a risk of interruption in
the maternal-fetal oxygen pathway due to the potential issue with maternal inhalation
(asthma) and the potential for umbilical cord compression (decreased amniotic fluid).
She has no identified issues with makernal or fetal circulation or with her placenta or
uterus.
A new nurse is learning about electronic fetal monitoring (EFM) while being
oriented to labor and delivery. Which of the following are true regarding EFM?
Select 2 answers.
a. Since continuous fetal monitoring has been implemented, there has been a
,decrease in fetal morbidity and mortality.
b. Continuous fetal monitoring is the most popular type of FHR monitoring in the
United States.
c. Wireless EFM allows freedom of movement while still continuously monitoring
the FHR.
d. AlI EFM devices are used continuously while a patient is in labor.
b. Continuous fetal monitoring is the most popular type of FHR monitoring in the United
States.
c. Wireless EFM allows freedom of movement while still continuously monitoring the
FHR.
Continuous FM is the most common type of intrapartum FHR monitoring in use today,
even though there has been no evidence that it has lowered cerebral palsy rates,
perinatal death, neonatal death, low AGAR scores, or rates of neonatal encephalopathy
(Sartwelle, Johnston 2018). FM is performed using either a handheld Doppler
ultrasound device or external ultrasound transducer. Wireless
EFM allows the patient to move about without being tethered to the monitor base.
EFM devices may be used intermittently or continuously in labor.
Each type of deceleration on the FHR tracing points to a distinct underlying
cause. Knowledge of the etiologies underlying each deceleration type is
important when choosing corrective interventions. Risk factors for late
decelerations include which of the following?
Select all that apply.
a. Maternal asthma
b. Intrauterine growth restriction
c. 42 weeks' gestation
d. Oligohydramnios
a. Maternal asthma
b. Intrauterine growth restriction
c. 42 weeks' gestation
Fetal factors: IUGR, hypoxia, tachycardia, hyperthermia
Although Category II patterns do not predict abnormal fetal acid-base status, they
require which of the following?
Select all that apply.
a Immediate delivery
, b More frequent evaluation
c. Continued surveillance with documentation
d. Initiation of appropriate corrective measures when indicated
b c. d.
Category II FHR patterns are considered indeterminate, meaning they do not predict
abnormal fetal acid-base status. They require more frequent evaluation, initiation of
corrective measures when indicated, and ongoing assessment for progressive changes
in the FHR characteristics. Failure to do so may result in the deterioration of the pattern
to Category IlI that is strongly predictive of abnormal fetal acid-base status.
Ms. Goldberg is in labor. Her fetal tracing is showing a prolonged deceleration
that has lasted 4 minutes in spite of repositioning the patient and discontinuing
the oxytocin infusion. Her current Sa02 is 90%. Which additional interventions
could be considered at this time?
Select all that apply.
A. Vaginal examination for prolapsed cord
b. Application of oxygen via tight face mask for 15-30 minutes
c. Palpate uterus
d. Digital scalp stimulation to provoke FHR acceleration
a, b
Although an evoked FHR acceleration can provide reassurance regarding the absence
of current fetal acidemia, this is true only when scalp stimulation is performed while the
FHR is at baseline. Scalp stimulation during a deceleration can cause a vagal response,
further decreasing the FHR.
Appropriate interventions for a prolonged deceleration include repositioning the patient,
performing a vaginal exam to rule out a cord prolapse, discontinuation of uterine
stimulants, and application of supplemental maternal oxygen for 15-30 minutes.
Repositioning the patient may increase uterine perfusion by alleviating the pressure of
the aorta and vena cava. It may also reposition the fetus alleviating cord compression
by the fetus.
For a sudden prolonged deceleration, it is important to perform a vaginal exam to
ensure that a cord did not prolapse, requiring an immediate intervention to relieve
compression and cesarean delivery.
Discontinuation of uterine stimulants, such as oxytocin, may lessen uterine contractions
allowing for increased oxygenation to the fetus.
Short-term application of oxygen to the mother may improve fetal oxygenation, but long-
term use may be detrimental to the fetus and should be discouraged. More data is
needed on the long-term use of oxygen on the mother and fetus (Lyndon, Wiser 2021).
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