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What should be checked prior to an obstetric examination?
Patient's ID and the need for a chaperone.
The fundus can usually be palpated abdominally before 12 weeks of gestation.
False
What position should the patient be in for an obstetric examination?
What is the normal fetal heart rate range?
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Match the following outcomes to their descriptions:
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Accurate palpation requires _____ and _____.
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What should be documented after the fetal heart assessment?
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What is one of the primary functions of the lymphatic system?
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Which of the following correctly describes the difference between lymphatic and venous capillaries?
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What is the function of lymph nodes within the lymphatic system?
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Which statement accurately reflects the content of lymph?
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Which of the following statements is true regarding the major lymphatic ducts?
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Study Notes
Prior to Examination
- Ensure a warm, private environment and check patient ID.
- Consider the need for a chaperone.
- Perform hand hygiene, ensuring hands are warm.
- Introduce yourself and clarify your status.
- Explain the necessity of palpating the abdomen to the patient.
- Obtain verbal consent before proceeding.
- Ensure the patient has emptied her bladder to minimize discomfort.
- Position the patient supine with only the head and upper shoulders supported by a pillow.
Inspection
- Inspect the abdomen for shape, size, scars, linea nigra, striae, movements, and color.
- Palpate the abdomen to assess growth (gestational age via fundal height), fetal movements, and fetal parts.
- Determine the number, lie, position, presentation, and engagement of the fetus.
Auscultation
- Use a fetal stethoscope (Pinard or sonicaid) to auscultate fetal heart rate.
Palpation Techniques
- Maintain patient dignity by exposing only necessary areas.
- Use warm hands and gentle, even movements of the flat palmar surface.
- Avoid prodding or jerky movements to prevent uterine irritation.
Key Points to Record
- Accurate palpation requires practice and experience.
- Document:
- Fundal height
- Lie of the fetus
- Presentation
- Position
- Engagement
- Fetal heart rate
- Uncertain or abnormal findings may necessitate further investigation via ultrasound.
Measuring Fundal Height
- Palpate the fundus, usually not detectable before 12 weeks gestation.
- Apply gentle pressure and measure from the fundus to the superior border of the symphysis pubis using a tape measure.
Identifying Lie and Presentation
- Palpate down the body of the uterus to identify the lie (smooth back vs. irregular limbs).
- Differentiate between fetal parts (e.g., breech feels softer than the head).
Assessing Fetal Heart Rate
- Auscultate the fetal heart using a stethoscope placed over the baby's back, ideally near the shoulder for clarity.
- Count the fetal heart rate for one minute while simultaneously palpating the mother's pulse.
- Normal fetal heart rate ranges from 110 to 160 beats per minute.
Recording Findings
- Report observations and document:
- Fundal height in CM
- Lie of the fetus
- Presentation
- Position
- Engagement status
- Fetal heart rate
- Any other relevant findings
Lymphatic System Overview
- A closed system made of lymphatic capillaries that drain approximately 10% of intestinal fluid/lymph from tissues.
Benefits of the Lymphatic System
- Drains large protein molecules synthesized in tissues.
- Functions as the body’s defense mechanism via lymph nodes.
- Provides an alternative route for fluid drainage when there’s a blockage in the venous system.
Similarities with the Venous System
- Both originate from tissue.
- Contain unidirectional valves to prevent backflow.
- Utilize muscular pumps to assist fluid movement.
Differences between Lymphatic and Venous Systems
- Lymphatic capillaries have larger pore sizes compared to venous capillaries.
- Lymphatic capillaries drain lymph, while veins transport deoxygenated blood.
- Lymph is filtered through lymph nodes before it is drained, unlike blood in veins.
Lymph Characteristics
- Drained by lymphatic capillaries.
- Composition is similar to plasma but contains higher concentrations of white blood cells and proteins.
- Lacks red blood cells and platelets.
Lymph Nodes
- Nodular structures rich in B-lymphocytes and T-lymphocytes.
Functions of Lymph Nodes
- Absorb excess interstitial fluid.
- Destroy pathogenic microorganisms.
- Act as the “traffic police” of the human body, regulating lymph flow.
Major Lymphatic Organs
- Spleen
- Thymus
- Tonsils
Absence of Lymphatic System in Specific Organs
- Brain
- Bone
Pressure in Lymphatic Blood Vessels
- Ranges from 1-2 mm/Hg.
Major Lymphatic Ducts
- Right Lymphatic Duct: drains lymph from the right upper part of the body and opens into the right subclavian vein.
- Left Lymphatic Duct (Thoracic Duct): drains lymph from the right lower part and the entire left side of the body, opening into the left subclavian vein.
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Description
This quiz covers essential procedures for conducting obstetric examinations. It includes patient preparation, consent, positioning, and hygiene practices necessary for a successful examination. Understanding these protocols is crucial for healthcare professionals in obstetrics.
