NCC EFM CERT| 41QUESTIONS| WITH
COMPLETE SOLUTIONS
EFM paper speed - 3cm/ minute
Ultra sound (EFM) - US transducer detects motion through ultrahigh frequency sound waves - it
determines FHR by auto correlation compares successive reflected ultra sound waveforms at
many points
FSE - fetal scalp electrode (ISE) measures interval between R waves
Value of EFM - used as a screen test, not considered diagnostic - normal EFM tracing = grater
than 99% chance fetus with not have neurologic injury
Normal FHR pattern detects what? - Intact CNS, oxygenation of the brainstem, ANS and intact
heart
sympathetic nervous system - FHR regulation, develops 1st in the fetus.
Release of norepinephrine/ epinephrine = increase in FHR
parasympathetic nervous system - FHR regulation
Release acetylcholine = a decrease in FHR (vagal)
*** responsible for producing variability as the fetus matures
- variability requires a mature neuro system
Baroreceptors - stretch receptors - respond to changes in BP =
-Abrupt decrease in FHR
-abrupt decrease in CO2
-abrupt decrease in BP
** variable decelerations w/ moderate variability are baroreceptor influenced
Chemoreceptors - Respond to changes in o2,co2, and pH levels
When blood flow is below threshold for normal respiratory gas exchange, increase in PCO2
stimulates Chemoreceptors to slow FHR
increase in PCO2, Decrease in O2, decrease in pH = vagal response (decrease in HR in response
to hypoxemia)
COMPLETE SOLUTIONS
EFM paper speed - 3cm/ minute
Ultra sound (EFM) - US transducer detects motion through ultrahigh frequency sound waves - it
determines FHR by auto correlation compares successive reflected ultra sound waveforms at
many points
FSE - fetal scalp electrode (ISE) measures interval between R waves
Value of EFM - used as a screen test, not considered diagnostic - normal EFM tracing = grater
than 99% chance fetus with not have neurologic injury
Normal FHR pattern detects what? - Intact CNS, oxygenation of the brainstem, ANS and intact
heart
sympathetic nervous system - FHR regulation, develops 1st in the fetus.
Release of norepinephrine/ epinephrine = increase in FHR
parasympathetic nervous system - FHR regulation
Release acetylcholine = a decrease in FHR (vagal)
*** responsible for producing variability as the fetus matures
- variability requires a mature neuro system
Baroreceptors - stretch receptors - respond to changes in BP =
-Abrupt decrease in FHR
-abrupt decrease in CO2
-abrupt decrease in BP
** variable decelerations w/ moderate variability are baroreceptor influenced
Chemoreceptors - Respond to changes in o2,co2, and pH levels
When blood flow is below threshold for normal respiratory gas exchange, increase in PCO2
stimulates Chemoreceptors to slow FHR
increase in PCO2, Decrease in O2, decrease in pH = vagal response (decrease in HR in response
to hypoxemia)
