NCC Electronic Fetal Monitoring Certification
Question and Answer | A+ Verified Answers |
Study Pack
• FHR Descriptors -✓✓1) Baseline
2) Variability
3) Presence of accels
4) Presence of decels
5) Changes in trends overtime
• FHR Baseline -✓✓Average FHR rounded to nearest 5 during a 10 min window
-110 to 160
-excludes accels, decels, & marked variability
-must have 2 mins to identify as a baseline (doesn't need to be continuous)
• Intermediate Baseline -✓✓- Less than 2 minutes of identifiable baseline during 10
minute window
- Clinician would need to refer to previous portions of the strip to determine baseline
• Fetal Bradycardia -✓✓<110 for ≥10 min
-Causes: hypotension (ex: after epi), cord prolapse, head compression, congenital
defect, rapid descent, abruption or rupture, tachysystole, post dates, hypoglycemia,
lupus (heart block)
-With ↓ O2, blood will be shunted to brain, heart, & adrenals, eventually ↓ FHR to ↓ O2
demands of heart muscle
-Verify not mom's HR, vaginal exam (r/o prolapse), resuscitate, evaluate arrhythmia,
expedite delivery
• Fetal Tachycardia -✓✓>160 for ≥10 min
-Causes: fetal anemia, maternal fever or infection, fetal immaturity (preterm), SVT,
maternal anxiety (catecholamines), dehydration, hyperthyroid, hypoxia
-Med causes: terbutaline, catecholamines (epinephrine, norepi)
-Assess mom's temp & infection risk (GBS, PROM)
• Sinusoidal baseline -✓✓- Smooth, Sine wave-like undulating pattern in FHR baseline
w/ a cycle frequency of 3 to 5 per minute that persist for at least 20 minutes.
• Baseline changes -✓✓FHR sustains a new rate for greater than or equal to 10
minutes. If less than 10 minutes.. temp. change (Long accels?, Deccels?)
• FHR Variability -✓✓Irregular in amplitude & frequency, quantified by peak to trough
-Caused by sympathetic vs parasympathetic, r/t neuro maturity
-Less in preterm due to undeveloped CNS
, -Absent: undetectable, flat
-Minimal: ≤5 bpm but detectable
-Moderate: 6-25 bpm
-Marked: >25 bpm (indeterminate baseline), significance unknown
• Minimal variability -✓✓≤5 bpm but detectable
Sleep, sedated, or sick
-Sleep cycle: 20-60 mins
-Sedated: CNS depressant (ex: mag), 1-2 hrs
-Sick (acidemia): unresolved w intervention
-Priority: maximize oxygenation (position, bolus, O2 if needed)
• Moderate variability -✓✓6 to 25 bpm
-Reliably predicts the absence of metabolic acidosis (even w decels)
• Marked Variability -✓✓- FHR variability that >25 BPM
- Normal Varient
- Reflects autonomic perturbation in the setting of early Hypoxemia
• Absent Variability -✓✓absent if the amplitude range of the FHR fluctuates is
undetectable to the unaided eye.
• FHR Accelerations -✓✓Reliably predicts absence of metabolic acidemia (spontaneous
or stimulated)
-Onset to peak in <30 sec
-For ≥32 wks: 15x15 (peak ≥15 bpm above baseline lasting ≥15 sec)
-For <32 wks: 10x10
-Prolonged accel: 2-9 mins (at 10 becomes change of baseline)
• Tachysystole -✓✓- more than 5 contractions in 10 minutes
• Decreased Blood Flow - Abnormal Uterine Activity -✓✓- Blood flow to the baby
happens between contractions, not during them - If ctx are too frequent or too long there
is not enough recovery time for oxygen to get back to the baby
• Early deceleration -✓✓Nadir aligns w contraction peak, gradual onset (≥30 secs to
nadir), benign vagal response
1) Pressure on fetal head
2) Increased intracranial pressure
3) Alteration in cerebral blood flow
4) Central vagal stimulation
5) FHR deceleration
• Periodic vs Episodic -✓✓Periodic: caused by contractions
-recurrent: occurs w ≥50% of contractions in 20 min
Question and Answer | A+ Verified Answers |
Study Pack
• FHR Descriptors -✓✓1) Baseline
2) Variability
3) Presence of accels
4) Presence of decels
5) Changes in trends overtime
• FHR Baseline -✓✓Average FHR rounded to nearest 5 during a 10 min window
-110 to 160
-excludes accels, decels, & marked variability
-must have 2 mins to identify as a baseline (doesn't need to be continuous)
• Intermediate Baseline -✓✓- Less than 2 minutes of identifiable baseline during 10
minute window
- Clinician would need to refer to previous portions of the strip to determine baseline
• Fetal Bradycardia -✓✓<110 for ≥10 min
-Causes: hypotension (ex: after epi), cord prolapse, head compression, congenital
defect, rapid descent, abruption or rupture, tachysystole, post dates, hypoglycemia,
lupus (heart block)
-With ↓ O2, blood will be shunted to brain, heart, & adrenals, eventually ↓ FHR to ↓ O2
demands of heart muscle
-Verify not mom's HR, vaginal exam (r/o prolapse), resuscitate, evaluate arrhythmia,
expedite delivery
• Fetal Tachycardia -✓✓>160 for ≥10 min
-Causes: fetal anemia, maternal fever or infection, fetal immaturity (preterm), SVT,
maternal anxiety (catecholamines), dehydration, hyperthyroid, hypoxia
-Med causes: terbutaline, catecholamines (epinephrine, norepi)
-Assess mom's temp & infection risk (GBS, PROM)
• Sinusoidal baseline -✓✓- Smooth, Sine wave-like undulating pattern in FHR baseline
w/ a cycle frequency of 3 to 5 per minute that persist for at least 20 minutes.
• Baseline changes -✓✓FHR sustains a new rate for greater than or equal to 10
minutes. If less than 10 minutes.. temp. change (Long accels?, Deccels?)
• FHR Variability -✓✓Irregular in amplitude & frequency, quantified by peak to trough
-Caused by sympathetic vs parasympathetic, r/t neuro maturity
-Less in preterm due to undeveloped CNS
, -Absent: undetectable, flat
-Minimal: ≤5 bpm but detectable
-Moderate: 6-25 bpm
-Marked: >25 bpm (indeterminate baseline), significance unknown
• Minimal variability -✓✓≤5 bpm but detectable
Sleep, sedated, or sick
-Sleep cycle: 20-60 mins
-Sedated: CNS depressant (ex: mag), 1-2 hrs
-Sick (acidemia): unresolved w intervention
-Priority: maximize oxygenation (position, bolus, O2 if needed)
• Moderate variability -✓✓6 to 25 bpm
-Reliably predicts the absence of metabolic acidosis (even w decels)
• Marked Variability -✓✓- FHR variability that >25 BPM
- Normal Varient
- Reflects autonomic perturbation in the setting of early Hypoxemia
• Absent Variability -✓✓absent if the amplitude range of the FHR fluctuates is
undetectable to the unaided eye.
• FHR Accelerations -✓✓Reliably predicts absence of metabolic acidemia (spontaneous
or stimulated)
-Onset to peak in <30 sec
-For ≥32 wks: 15x15 (peak ≥15 bpm above baseline lasting ≥15 sec)
-For <32 wks: 10x10
-Prolonged accel: 2-9 mins (at 10 becomes change of baseline)
• Tachysystole -✓✓- more than 5 contractions in 10 minutes
• Decreased Blood Flow - Abnormal Uterine Activity -✓✓- Blood flow to the baby
happens between contractions, not during them - If ctx are too frequent or too long there
is not enough recovery time for oxygen to get back to the baby
• Early deceleration -✓✓Nadir aligns w contraction peak, gradual onset (≥30 secs to
nadir), benign vagal response
1) Pressure on fetal head
2) Increased intracranial pressure
3) Alteration in cerebral blood flow
4) Central vagal stimulation
5) FHR deceleration
• Periodic vs Episodic -✓✓Periodic: caused by contractions
-recurrent: occurs w ≥50% of contractions in 20 min
