An Introduction to Fetal Heart Monitoring

An Introduction to Fetal Heart Monitoring 

This program presents basic concepts in fetal heart monitoring for bedside perinatal care providers. It is divided into five sections, each of which discusses a separate topic and reinforces key elements of fetal assessment and oxygenation:

 

  • Maternal and fetal physiology
  • Uterine activity and fetal assessments
  • The instrumentation used in fetal monitoring
  • Monitoring  and tracing characteristics and selection of clinical interventions
  • Risk management strategies

 

 

Knowledge checks and section Questions and Answers highlight key learning points. Practice exercises and case studies are designed to reinforce the importance of clinicians’ assessments and decisions and their effect on patient care.



$70.00

Hours: 2.80
REL-ACU-AWHONN-IFHM

Certificates

Certificates provided by accrediting body (1 Match)

Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)

2.8 HOURS


Association of Women’s Health, Obstetric and Neonatal Nurses is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. AWHONN is approved by the California Board of Registered Nursing, Provider #CEP580.

Course Details

Course Code: REL-ACU-AWHONN-IFHM
Hours: 2.8
Type: Online Course
Content Expiration Date: 12/31/2022
Learning Objectives:
Delineate the physiological and anatomical aspects of maternal-fetal circulation.
Describe the information about fetal heart rate (FHR) and uterine activity provided by auscultation and palpation.
Define FHR uterine activity characteristics obtained via electronic fetal monitoring.
Interpret electronic fetal heart rate and uterine patterns.
Articulate risk management strategies related to fetal heart monitoring.

Outline:

Section 1: Introduction



Introduction



Objectives



Rationale



Section 2: Maternal-Fetal Physiology



Introduction



Objectives



Overview



Physiological Adaptations of Pregnancy



Viewing the maternal fetal exchange: animation



The oxygen exchange



Concept: The Mother



The Placenta



The Placenta and the uterus



The villi and the intervillous space



Passive Diffusion



Summary



The Fetus



The Fetus and the Umbilical cord



Cord Compression



Cord Compression and Variable Decelerations



The Fetal Reserve



Transient Interruptions



Decreased Placental Function



Summary



Auscultation: Introduction



Leopold’s Maneuvers



Listening to the Fetal Heart



Distinguishing the Maternal and Fetal Heartbeats



Listening: the Fetoscope



Listening: the Doppler



Procedure for Auscultation



Limitations



Maternal-Fetal Physiology: Questions



Conclusions



Summary



Section 3: Uterine and Fetal Assessment



Introduction



Objectives



Overview



Concept: Introduction



Uterine Monitoring Tools



Fetal Heart Rate Monitoring Tools



Using the Monitor



Monitor Paper



Uterine Activity Format



Detecting Uterine Activity



Duration and Frequency



Recording the Fetal Heart Rate



Components of Uterine Activity



Resting Tone



Frequency



Duration



Intensity



Montevideo Units



Measuring Uterine Activity



Palpatation Basics



Palpatation Techniques



Palpatation Assessments



Palpatation Assessments|Knowledge Check



Palpatation Limitations



Palpatation Summary



Electronic Instruments Overview



Tocodynamometer (Toco)



Intrauterine Pressure Catheter (IUPC)



Monitoring the fetal heart rate and fetal heart rate characteristics



Baseline



Fetal Heart Physiology



Physiologic Factors and Fetal Heart Rate



Fetal Physiologic Responses



The Fetal Central Nervous System



Fetal Heart Rate and Gestation



Bradycardia



Variability



Classification



Undulating Patterns



Variability



Accelerations in FHR



Decelerations of the Fetal Heart Rate



Decelerations



Variations in the FHR of the Preterm Fetus



Maternal-Fetal Physiology: Questions



Summary



Section 4: Electronic Instrumentation



Introduction



Objectives



Overview



External Electronic Uterine and Fetal Monitoring



Internal Electronic Uterine and Fetal Monitoring



The Tracing



The Instruments



Doppler Ultrasound Transducer



Doppler Ultrasound



Doppler Shift



Graphic Tracing of the Fetal Heart Rate



Artifact



Application of Doppler Ultrasound



Leopold’s Maneuvers



Leopold’s Maneuvers: First Maneuver



Leopold’s Maneuvers: Second Maneuver



Leopold’s Maneuvers: Third Maneuver



Leopold’s Maneuvers: Fourth Maneuver



Ultrasound Troubleshooting



Capabilities, Advantages, and Disadvantages of the Ultrasound



Fetal Spiral Electrode



Fetal Spiral Electrode: Animation



ECG R Wave Animation



Application



Capabilities, Advantages, and Disadvantages of the Fetal Spiral Electrode



Troubleshooting



The Tocodynamometer



The Tracing



Uterine Contraction Variations



Application



Troubleshooting



Advantages and Limitations



Toco Placement



Intrauterine Pressure Catheter



The Transducer- and Sensor-Tipped Catheters



The Choice of Catheters



The Tracing



Intrauterine Pressure Catheter | Animation



Intrauterine Pressure Catheter | Application



Troubleshooting and Limitations



Assessment & Interventions: Questions



Summary



Section 5: Monitoring and Interventions



Introduction



Objectives



Overview



Pattern Characteristics: Accelerations



Accelerations Physiology



Pattern Characteristics: Decelerations



Early Decelerations



Late Decelerations



Physiology of Late Decelerations



Late Decelerations and Fetal Status



Variable Decelerations



Variable Decelerations and Fetal Status



Overshoots



Episodic Decelerations



Prolonged Decelerations



Episodic Deceleration Examples



The 3-tier Fetal Heart Rate Interpretation System



Category I (Normal) Fetal Heart Rate Tracings



Scalp Stimulation



Vibroacoustic Stimulation



Category II (Indeterminate) Fetal Heart Rate Tracings



Category III (Abnormal) Fetal Heart Rate Tracings



Interventions



Intrauterine Resuscitation



Pharmacologic Interventions



Other Interventions



Fetal Heart Rate Assessments and Uterine Activity



The Case



Case Interventions



Monitoring and Interventions: Questions



Summary



Section 6: Risk Management through Communication



Introduction



Objectives



Overview



Risk Management



Identifying Areas of Potential Liability



Documentation Issues



Culture of Safety



Risk Management and Perinatal Nursing



Challenges



Professional Organizations



Publication Guidelines



Verbal Communication



Communication with the Primary Healthcare Provider



Effective Communication



Factors Limiting Communication



Opening Up Communication



Common Terminology



The SBAR and SBARR Models



Transition/Hand-off to Other Nurses



The SWAP Model



Documentation



What Should Be Documented



The Medical Record



Legibility



Elements of Documentation



The Method of Monitoring



Frequency of Electronic Fetal Monitoring Evaluation: Low-Risk and High-Risk Patients



Points at Which to Monitor



Late Entries



Documentation of Emergency



Flow Sheet



Narrative Notes



The Importance of Documentation



The Chain of Resolution/Authority/Command: Introduction



The Steps of the Process



The Chain of Resolution/Chain of Authority/Chain of Command



The Caregiver’s Responsibilities



The Organization’s Responsibility



Risk Management through Communications: Questions



Summary


Target Audience:
The target audience for this course is: Nurses; Physicians; in the following settings: Acute Care Facility.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
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All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
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All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
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