EFM - Electronic Fetal Monitoring Intrauterine Resuscitation Techniques Questions and Answers

Question 1

A laboring patient with an EFM tracing showing recurrent late decelerations and minimal variability is placed in a left lateral position. What is the primary physiological goal of this intervention?

Accepted Answer

To increase maternal cardiac output and improve uteroplacental perfusion.

Answer

To alleviate direct compression of the umbilical cord.

Answer

To dislodge the fetal head from the pelvis.

Answer

To stimulate a fetal vagal response and lower the heart rate.

Question 2

Which of the following intrauterine resuscitation techniques is specifically indicated for the management of recurrent variable decelerations believed to be caused by umbilical cord compression?

Accepted Answer

Instillation of warmed normal saline via an intrauterine pressure catheter (Amnioinfusion).

Answer

Administration of a 500 mL IV fluid bolus of lactated Ringer's.

Answer

Discontinuation of oxytocin infusion.

Answer

Application of 10 L/min of oxygen via a non-rebreather mask.

Question 3

A patient receiving oxytocin for labor augmentation develops uterine tachysystole (six contractions in 10 minutes) accompanied by recurrent late decelerations. What is the FIRST priority nursing intervention?

Accepted Answer

Discontinue the oxytocin infusion.

Answer

Administer a subcutaneous dose of terbutaline.

Answer

Increase the rate of the primary IV infusion.

Answer

Place the patient in a Trendelenburg position.

Question 4

When supplemental oxygen is administered as an intrauterine resuscitation measure for a Category II or III fetal heart rate tracing, what is the generally recommended method and flow rate?

Accepted Answer

10 L/min via a non-rebreather face mask.

Answer

5 L/min via a simple face mask.

Answer

2-4 L/min via nasal cannula.

Answer

100% FiO2 via a bag-valve-mask.

Question 5

A G1P0 patient at 39 weeks gestation develops hypotension (BP 85/50 mmHg) immediately following epidural placement. The EFM tracing shows a prolonged deceleration to 70 bpm. In addition to notifying the provider, which combination of interventions is most appropriate?

Accepted Answer

Initiate left lateral positioning and administer an IV fluid bolus.

Answer

Administer terbutaline and initiate amnioinfusion.

Answer

Start oxytocin and perform a cervical exam.

Answer

Apply fundal pressure and encourage the patient to push.

Question 6

The primary purpose of administering an intravenous (IV) fluid bolus of an isotonic solution during intrauterine resuscitation is to:

Accepted Answer

Increase maternal intravascular volume to improve placental perfusion.

Answer

Correct fetal dehydration.

Answer

Dilute meconium in the amniotic fluid.

Answer

Decrease the intensity of uterine contractions.