Name:_______________________________

Fetal Monitoring Case Studies

1. Nurses caring for laboring women use a variety of methods to assess fetal health and
well-being during labor. State the advantages and disadvantages of each of the
following methods to assess FHR and pattern as well as uterine activity. Outline the
nursing care measures required for each of the monitoring methods.

a. External Fetal Monitoring

b. Internal Fetal Monitoring

2. Terry is a primigravida at 43 weeks of gestation. Her labor is being stimulated with

oxytocin administered IV. Her contractions have been increasing in intensity with a
frequency of every 2 to 2.5 minutes and a duration of 80 to 85 seconds. She is currently
in a supine position with a 30-degree elevation of her head. On observation of the
monitor tracing, you note that during the last two contractions, the FHR decreased after
the contraction peaked and did not return to baseline until about 10 seconds after the
contraction ended. A slight decrease in variability and baseline rate were observed.

a. Identify the fetal heart rate pattern and describe the possible factors responsible
for it.

b. Describe the PRIORITY (2-3) nursing interventions and include rationales.

3. Taisha is a multiparous woman in active labor. Her membranes rupture and the nurse
caring for her immediately evaluates the fetal heart rate tracing.

a. What type of periodic FHR pattern would the nurse be alert for when evaluating
the tracing? Explain the rationale for your answer.

b. State the actions the nurse should take in order of PRIORITY if the pattern is
noted.

4. A laboring woman’s temperature is elevated as a result of an upper respiratory

infection. Which of the following FHR patterns would be present in a woman with a
fever?
a. Tachycardia
b. Diminished variability
c. Variable deceleration
d. Early decelerations

5. A nulliparous woman is in the active phase of labor and her cervix has progressed to 6
cm dilation. The nurse caring for this woman evaluates the external monitor tracing and
notes the following: Decrease in FHR shortly after the onset of several uterine
contractions, returning to baseline by the end of the contraction, the shape is uniform.
Based on these findings, the nurse should do which of the following?
a. Change the woman’s position to her left side.
b. Document the finding on the woman’s chart.
c. Notify the physician.
d. Perform a vaginal examination to check for cord prolapse.