North American Registry of Midwives (NARM) Practice Exam

What circumstances indicate the need for an additional FHT check during labor?

1. After a woman's medication is administered

2. When a sudden change in the U/C or labor pattern occurs

3. After expulsion of an enema

4. All of the above

The correct answer is: All of the above

Additional fetal heart tone (FHT) checks are warranted in various specific circumstances to ensure the well-being of the fetus during labor. Each scenario presented has relevance to fetal monitoring. When medication is administered to the woman, particularly medications that may affect uterine contractions or the overall maternal condition, it is important to assess the fetal heart tones afterward. This ensures that the medication has not adversely affected fetal well-being. A sudden change in the uterine contraction (U/C) pattern or labor itself signals potential complications that might affect fetal oxygenation. This could include a significant increase or decrease in contractions, or a change from regular to irregular contractions, prompting further monitoring to assess the fetal response. The expulsion of an enema can also warrant an additional FHT check. This is due to the physiological changes that may occur with the increased intra-abdominal pressure or discomfort that could affect the fetus. Taking all these factors into consideration, it becomes clear that in any of these scenarios, additional monitoring of fetal heart tones is critical to ensure that the fetus is tolerating labor well and to identify any potential problems that may arise. Therefore, all the circumstances highlighted necessitate further checks on fetal heart tones during labor.