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Electronic Fetal Monitoring Exam Review

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Course Description

This course will review test content outline and the associated competencies to prepare for the 2012 NCC subspecialty examination in Electronic Fetal Monitoring. Content will include fetal heart monitoring (FHM) pattern recognition and interpretation using NICHD definitions; review of the physiology of maternal fetal oxygenation and other factors impacting on the neuromodulation of fetal heart rate, complications of labor and the potential effects on FHM data; review interventions and management targeted to the physiology of FHR patterns. Content will be applied in the context of case studies. Adjunct fetal assessment, legal aspects of FHM and equipment troubleshooting will be reviewed.

Program Learning Outcomes

This program prepares the learner to:

  • Apply NICHD terminology to fetal heart rate pattern recognition, interpretation and assessment.
  • Discuss factors affecting fetal oxygenation, including fetal heart rate regulation; maternal and fetal physiology; complications of pregnancy and labor, drug effects and dysrhythmias.
  • Review appropriate nursing interventions and actions targeted to the physiology of the FHM patterns.
  • Discuss adjunct fetal assessment, including fetal acid base interpretation and the biophysical profile.
  • Incorporate knowledge of legal responsibilities and liabilities related to FHM data into a plan of care.


Sign-in begins at 7:30 am. The day includes a one-hour lunch (on your own), as well as a morning and afternoon break of 15 minutes each. The order of lectures presented and break times may vary according to speaker preference.

8:00 am to 4:30 pm

  • About the Test, Test-Taking Skills
    Scheduling the Test, Computer Testing Overview | How Multiple Choice Questions are Constructed | Study Tips and Skills | Managing Test Anxiety
  • Equipment Overview and Patient Education
    Internal vs. External FHR and Uterine Contraction Monitoring | Equipment Failure and Troubleshooting | Continuous vs. Intermittent Monitoring | Positioning and Movement in Labor | Volume Control | Normal Patterns of FHR
  • Physiology of Fetal Oxygenation: Extrinsic Factors
    Maternal Cardiac Output | Maternal Medical History | Uterine Contraction Frequency, Duration and Intensity | Effects of Maternal Cardiac Output | Exchange Mechanisms | Alterations in Cord Blood Flow
  • Physiology of Fetal Oxygenation: Intrinsic Factors
    Autonomic Nervous System: Sympathetic and Parasympathetic | Alterations in Blood Pressure: Cord Compression | Alterations in Oxygenation: O2, CO2 and pH | Epinephrine, Norepinephrine, Renin and Angiotensin
  • Pattern Recognition, Interpretation and Intervention
    Baseline Rate | Baseline Variability | Accelerations | Decelerations | NICHC Classification of FHR and Implications for Care
  • Dysrhythmias and Variant Patterns
    SVT | Heart Block | Ectopic Beats
  • Complications of Pregnancy and Birth
    Preterm Patterns | Hypertensive Disorders | Postdates Pregnancy | Diabetes | Infections | Multi-Fetal Pregnancy
  • Adjunct Fetal Assessment
    Adjunct Methods of Fetal Assessment | Fetal Cord Blood Acid Base Results
  • Legal Aspects of Fetal Monitoring and Chain of Command
    Elements of Nursing Documentation for EFM Data | Chain of Command and Nursing Failure to Rescue
  • Q & A Session