FHR MONITOR
Explain how to identify the baseline FHR. Correct Answer: The baseline FHR is determined by
approximating the mean FHR rounded to increments of 5 beats per minute during a ten minute
window. (There must be a 2 minute window of identifiable baseline segments)
Explain absent FHR variability. Correct Answer: amplitude range undetectable
Explain minimal FHR variability. Correct Answer: amplitude range greater than undetectable
and less than or equal to 5 bpm
Explain Moderate FHR variability. Correct Answer: Amplitude range from 6 bpm to 25 bpm
Explain Marked FHR variability Correct Answer: amplitude range greater than 25 bpm
What are the causes of decrease baseline FHR variability in the mother? Correct Answer:
Medications response, Drug response (CNS DEPRESSANTS, MORPHINE, DEMEROL,
NUBAIN, STADOL, NEMBUTAL, and ALCOHOL
What are the causes of decrease baseline FHR variability in the fetus? Correct Answer: fetal
sleep cycles, fetal CNS anomalies, prolonged or serve fetal hypoxia, cardiac anomalies,
persistent fetal tachycardia, excessive/prolonged parasympathetic (vagal) stimulation
Explain Deceleration Correct Answer: FHR decrease of at least 15 bpm that last less than 2
minutes
Explain Prolonged Deceleration Correct Answer: FHR decrease of at least 15 bpm that lasts
longer than 2 minutes but less than 10 minutes
What are the maternal causes of FHR Bradycardia? Correct Answer: maternal supine
positioning, maternal hypotension, connective tissue diseases, and prolonged maternal
hypothermia, medications (Inderal, atenolol, and labetolol
What are the fetal causes of FHR Bradycardia? Correct Answer: umbilical cord
occlusion/prolapse, decompensating fetus, cardiac conduction defects, cardiac anatomic defects,
congenital heart disease, maturity of parasympathetic nervous system, excessive/prolonged
parasympathetic vagal stimulation
What are the maternal causes of FHR Tachycardia? Correct Answer: maternal fever/infection,
dehydration, hyperthyroidism, anemia, maternal anxiety, cigarette smoking, medication or drug
response (parasympatholytic drugs, beta sympathomimetic drugs, illicit drugs)
, What are the fetal causes of FHR
Tachycardia? Correct Answer: prolonged fetal activity/stimulation, chronic fetal hypoxemia,
compensatory response to transient fetal hypoxemia, chorioamnionitis, fetal cardiac
abnormalities, supraventricular tachycardia, fetal anemia
Explain Accelerations. Correct Answer: A visually apparent, abrupt increase is defined as an
increase from onset of acceleration to peak in less than 30 seconds. The peak must be greater
than or equal to 15 bpm and the acceleration must last greater than or equal to 15 seconds.
Normal Uterine Contractions are: Correct Answer: less than or equal to five contractions in 10
minutes, an average over 30 minutes
Tachysystole contractions are: Correct Answer: greater than 5 contractions in 10 minutes
average over a 30 minute window
Contraction intensity Correct Answer: strength of intrauterine pressure above baseline uterine
tone
Contraction Frequency Correct Answer: interval between the beginning of one contraction and
the beginning of the next one
Contraction Duration Correct Answer: length of time in seconds from the beginning of a
contraction to its resolution
Periodic Patterns Correct Answer: Patterns in the FHR associated with contractions
(acceleration or deceleration in the fetal hr that occur in direct association with uterine
contractions)
Episodic Pattern Correct Answer: Patterns in FHR not associated with uterine contractions (a
deceleration or acceleration in response to a vag exam, maternal vomiting, or fetal movements)
Fetal Tachycardia is indicative of Correct Answer: maternal or fetal infection, fetal hypoxia
(ominous sign), anticholinergic drugs, and betasympathomimetic drugs, maternal illicit drugs
such as cocaine, maternal anxiety, fetal anemia, maternal dehydration, amnionitits, and maternal
hyperthyroidism
Fetal Bradycardia is indicative of Correct Answer: fetal hypoxia or stress, maternal hypotension
after epidural initation, some fetus' have normal low baselines (investigate), tetanic uterine
contractions, paracervical block, epidural and spinal anesthesia, maternal seizure, rapid descent,
vigorous vaginal examination, maternal hypothermia, congenitial heart block, abruptio placenta,
fetal arrhythmia (complete heart block)
Interventions for fetal bradycardia: Correct Answer: place on left side, increase fluids to
counteract hypotension, stop oxytocin
Explain how to identify the baseline FHR. Correct Answer: The baseline FHR is determined by
approximating the mean FHR rounded to increments of 5 beats per minute during a ten minute
window. (There must be a 2 minute window of identifiable baseline segments)
Explain absent FHR variability. Correct Answer: amplitude range undetectable
Explain minimal FHR variability. Correct Answer: amplitude range greater than undetectable
and less than or equal to 5 bpm
Explain Moderate FHR variability. Correct Answer: Amplitude range from 6 bpm to 25 bpm
Explain Marked FHR variability Correct Answer: amplitude range greater than 25 bpm
What are the causes of decrease baseline FHR variability in the mother? Correct Answer:
Medications response, Drug response (CNS DEPRESSANTS, MORPHINE, DEMEROL,
NUBAIN, STADOL, NEMBUTAL, and ALCOHOL
What are the causes of decrease baseline FHR variability in the fetus? Correct Answer: fetal
sleep cycles, fetal CNS anomalies, prolonged or serve fetal hypoxia, cardiac anomalies,
persistent fetal tachycardia, excessive/prolonged parasympathetic (vagal) stimulation
Explain Deceleration Correct Answer: FHR decrease of at least 15 bpm that last less than 2
minutes
Explain Prolonged Deceleration Correct Answer: FHR decrease of at least 15 bpm that lasts
longer than 2 minutes but less than 10 minutes
What are the maternal causes of FHR Bradycardia? Correct Answer: maternal supine
positioning, maternal hypotension, connective tissue diseases, and prolonged maternal
hypothermia, medications (Inderal, atenolol, and labetolol
What are the fetal causes of FHR Bradycardia? Correct Answer: umbilical cord
occlusion/prolapse, decompensating fetus, cardiac conduction defects, cardiac anatomic defects,
congenital heart disease, maturity of parasympathetic nervous system, excessive/prolonged
parasympathetic vagal stimulation
What are the maternal causes of FHR Tachycardia? Correct Answer: maternal fever/infection,
dehydration, hyperthyroidism, anemia, maternal anxiety, cigarette smoking, medication or drug
response (parasympatholytic drugs, beta sympathomimetic drugs, illicit drugs)
, What are the fetal causes of FHR
Tachycardia? Correct Answer: prolonged fetal activity/stimulation, chronic fetal hypoxemia,
compensatory response to transient fetal hypoxemia, chorioamnionitis, fetal cardiac
abnormalities, supraventricular tachycardia, fetal anemia
Explain Accelerations. Correct Answer: A visually apparent, abrupt increase is defined as an
increase from onset of acceleration to peak in less than 30 seconds. The peak must be greater
than or equal to 15 bpm and the acceleration must last greater than or equal to 15 seconds.
Normal Uterine Contractions are: Correct Answer: less than or equal to five contractions in 10
minutes, an average over 30 minutes
Tachysystole contractions are: Correct Answer: greater than 5 contractions in 10 minutes
average over a 30 minute window
Contraction intensity Correct Answer: strength of intrauterine pressure above baseline uterine
tone
Contraction Frequency Correct Answer: interval between the beginning of one contraction and
the beginning of the next one
Contraction Duration Correct Answer: length of time in seconds from the beginning of a
contraction to its resolution
Periodic Patterns Correct Answer: Patterns in the FHR associated with contractions
(acceleration or deceleration in the fetal hr that occur in direct association with uterine
contractions)
Episodic Pattern Correct Answer: Patterns in FHR not associated with uterine contractions (a
deceleration or acceleration in response to a vag exam, maternal vomiting, or fetal movements)
Fetal Tachycardia is indicative of Correct Answer: maternal or fetal infection, fetal hypoxia
(ominous sign), anticholinergic drugs, and betasympathomimetic drugs, maternal illicit drugs
such as cocaine, maternal anxiety, fetal anemia, maternal dehydration, amnionitits, and maternal
hyperthyroidism
Fetal Bradycardia is indicative of Correct Answer: fetal hypoxia or stress, maternal hypotension
after epidural initation, some fetus' have normal low baselines (investigate), tetanic uterine
contractions, paracervical block, epidural and spinal anesthesia, maternal seizure, rapid descent,
vigorous vaginal examination, maternal hypothermia, congenitial heart block, abruptio placenta,
fetal arrhythmia (complete heart block)
Interventions for fetal bradycardia: Correct Answer: place on left side, increase fluids to
counteract hypotension, stop oxytocin
