Baseline
Variability
Decels
Category
Interventions
Grab Bag
100
110-160 bpm defined in increments of 5 bpm.
What is normal fetal heart baseline?
100
Determined in a 10-minute window excluding accelerations and decelerations.
What is baseline variability?
100
The onset, lowest point (nadir), and recovery of the deceleration occur at the same time as the onset, highest point, and recovery of the contraction
What is an early deceleration?
100
Fetal heart rate baseline 110-160 bpm
Moderate variability
Late or variables deceleration absent
Early deceleration absent or present
What is Category 1?
100
Continue to observe the patient
Document observations
Notify provider – “Routine” communication
What are the Nurse’s interventions for a Category I FHR strip?
100
Greater than 5 contractions in 10 minutes averaged over a 30-minute window. 
What is uterine tachysystole? 
200
Fetal heart rate less than 110 for greater than 10 minutes. 
What is Bradycardia?
200
Undetectable fetal heart rate range.
What is absent variability?
200
The decrease in fetal heart rate of greater than 15 bpm lasting greater than 15 seconds but less than 2 minutes from onset to return to baseline. 
What is a variable deceleration?
200
Minimal baseline variability with accelerations
Variable decelerations without slow return to baseline or overshoots
Single prolonged deceleration within 12 hours
What is Category II ?
200
Recognize and document Category ___ pattern
Institute intrauterine resuscitation
Request provider evaluation of fetal monitoring strip, communicate fetal/patient response
Document: observations, actions, and fetal/patient response
Anticipate the potential to transition to next Category
What is the Nurse’s role with a Category II FHR tracing?
200
The pressure exerted by uterine muscle cells and supportive tissues when they are at rest. 
What is uterine resting tone?
300
Fetal heart rate greater than 160 bpm for greater than 10 minutes.
What is Tachycardia?
300
Greater than undetectable but equal to or less than 5 bpm.
What is minimal variability?
300
Fetal heart rate with either gradual or abrupt decrease of greater than or equal to 15 bpm lasting greater than or equal to 2 minutes but less than 10 minutes from onset to return to baseline.
What is a prolonged deceleration?
300
Minimal baseline variability without accelerations lasting greater than 60 minutes
Absent baseline variability not accompanied by recurrent decelerations
Marked baseline variability
What is Category II?
300
Recognize and document Category ___ pattern
Institute intrauterine resuscitation as appropriate
Notify provider, communicate status
Document provider response
What is the Nurse’s role with this Category II FHR tracing?
300
A visually apparent, smooth, sine wave-like undulating pattern in fetal heart rate baseline with a cycle frequency of 3-5 cycle per minute that persists greater than 20 minutes. 
What is sinusoidal pattern?
400
Enhance Fetal Oxygenation trough:
Position Changes
Increasing Fluids
Applying Oxygen
What is intrauterine resuscitation?
400
Fetal heart fluctuation of 6-25 bpm. 
What is moderate variability?
400
The onset, lowest point (nadir), and recovery of the deceleration occurs after the onset, highest point, and recovery of the contraction with greater than 50 percent of contractions in any 20 minute segment. 
What is recurrent late decelerations? 
400
Tachycardia
Absent baseline fetal heart rate variability
Late recurrent decelerations
What is Category III?
400
Recognize and document Category ___ pattern
Institute intrauterine resuscitation
Require onsite assessment or intervention
Document provider response
Prepare for delivery
Activate team for emergency cesarean section
Prepare patient for delivery
Call for available OB/General surgeon
Document observations, actions, and fetal/patient response
What is the Nurse’s role with a Category III FHR tracing?
400
The sum of each contraction’s peak minus the resting tone in a 10 minute period.
What is montevideo units?
500
Speedy and Pokey nerve impulses. 
What are sympathetic and parasympathetic?
500
Fetal heart fluctuation of greater than 25 bpm.
What is marked variability?
500
When cord occlusion is released, the fetal heart rate goes above the baseline and then return to baseline over 40-60 seconds, hypoxemia is indicated.
What is an overshoot?
500
Institute intrauterine resuscitation
Prepare for delivery
Activate team for emergency c-section
Document provider response
What is the Nurse role in a Category III?
500
Implement Chain of Command protocol!
What is the nurse’s action if at any time the provider does not respond appropriately to any Category of FHR tracing?
500
•Standardized definitions to support processes and protocols
•Improved communication between the healthcare team
•Improved patient outcomes
What are NICHD Guidelines?