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Questions and Answers
What describes a multipara?
What describes a multipara?
How often should the Fetal Heart Rate be recorded on the partograph?
How often should the Fetal Heart Rate be recorded on the partograph?
What should be recorded in the Liquor section of the partograph?
What should be recorded in the Liquor section of the partograph?
What does the term 'Moulding' refer to in the partograph?
What does the term 'Moulding' refer to in the partograph?
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How is cervical dilatation recorded on the partograph?
How is cervical dilatation recorded on the partograph?
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Which of the following is monitored for contractions on the partograph?
Which of the following is monitored for contractions on the partograph?
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What is the purpose of recording the elapsed time since monitoring began on the partograph?
What is the purpose of recording the elapsed time since monitoring began on the partograph?
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What does the Descent of Head measure on the partograph?
What does the Descent of Head measure on the partograph?
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What is indicated when cervical dilatation remains on or to the left of the alert line during labor?
What is indicated when cervical dilatation remains on or to the left of the alert line during labor?
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What should you avoid doing if the membranes have ruptured and the woman has no contractions?
What should you avoid doing if the membranes have ruptured and the woman has no contractions?
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What symbol is used to plot the descent of the fetal head on the partograph?
What symbol is used to plot the descent of the fetal head on the partograph?
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At what station is the fetal head considered to be at the same level as the ischial spines?
At what station is the fetal head considered to be at the same level as the ischial spines?
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What does a negative station number indicate about the position of the fetal head?
What does a negative station number indicate about the position of the fetal head?
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What occurs at station +3 during labor?
What occurs at station +3 during labor?
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What happens at station -4 or -3 regarding the fetal head?
What happens at station -4 or -3 regarding the fetal head?
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What is a common way to determine the station of the fetal head?
What is a common way to determine the station of the fetal head?
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What is the primary purpose of the woman lying in a supine position during abdominal examination?
What is the primary purpose of the woman lying in a supine position during abdominal examination?
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Why is it important to expose only the area of the abdomen needed for palpation?
Why is it important to expose only the area of the abdomen needed for palpation?
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What might happen if the woman's bladder is not empty before the examination?
What might happen if the woman's bladder is not empty before the examination?
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Which of the following is NOT part of the methods used in abdominal examination?
Which of the following is NOT part of the methods used in abdominal examination?
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What does inspection of the abdomen help to determine?
What does inspection of the abdomen help to determine?
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What is the significance of the linea negra observed during inspection?
What is the significance of the linea negra observed during inspection?
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What technique should be used during palpation to avoid discomfort?
What technique should be used during palpation to avoid discomfort?
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Which skin condition indicates previous surgeries, especially a cesarean section?
Which skin condition indicates previous surgeries, especially a cesarean section?
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What does an Apgar score of 0 to 2 indicate for a newborn infant?
What does an Apgar score of 0 to 2 indicate for a newborn infant?
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At what times is the Apgar score assessed after birth?
At what times is the Apgar score assessed after birth?
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What is the maximum possible total score in the Apgar scoring system?
What is the maximum possible total score in the Apgar scoring system?
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Which of the following scores corresponds to a heart rate of ≥ 100 b.p.m in the Apgar score?
Which of the following scores corresponds to a heart rate of ≥ 100 b.p.m in the Apgar score?
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What is the ideal length of the umbilical cord mentioned in the procedures?
What is the ideal length of the umbilical cord mentioned in the procedures?
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What does the reflex irritability score of '1' indicate in the Apgar assessment?
What does the reflex irritability score of '1' indicate in the Apgar assessment?
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When should the umbilical cord be clamped and divided?
When should the umbilical cord be clamped and divided?
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Which of the following statements about the Apgar scoring system is NOT true?
Which of the following statements about the Apgar scoring system is NOT true?
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What event would NOT result in a point being subtracted from the scoring system?
What event would NOT result in a point being subtracted from the scoring system?
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Which situation is considered a contraindication for conducting a vaginal examination?
Which situation is considered a contraindication for conducting a vaginal examination?
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Which criteria are NOT included in the assessment during a vaginal examination?
Which criteria are NOT included in the assessment during a vaginal examination?
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What is the purpose of the Bishops score in a clinical procedure?
What is the purpose of the Bishops score in a clinical procedure?
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When should a vaginal examination be conducted after observing a non-reassuring fetal heart rate?
When should a vaginal examination be conducted after observing a non-reassuring fetal heart rate?
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What is one objective of perineal care?
What is one objective of perineal care?
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When should perineal care be performed after delivery?
When should perineal care be performed after delivery?
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What is indicated by pain and swelling around the vagina?
What is indicated by pain and swelling around the vagina?
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Which of the following should be done first in the perineal care procedure?
Which of the following should be done first in the perineal care procedure?
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How should the cleaning of the perineum be performed?
How should the cleaning of the perineum be performed?
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What type of discharge is expected after childbirth?
What type of discharge is expected after childbirth?
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What is the correct positioning of the woman during perineal care?
What is the correct positioning of the woman during perineal care?
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What is the final step in the perineal care procedure?
What is the final step in the perineal care procedure?
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Study Notes
Clinical Procedures of Obstetrics and Gynecological Nursing Part 2
- Topics covered in this part include:
- The Partograph
- Abdominal examination
- Immediate Care of the Newborn Baby
- Breast self-Examination
- Examination of the placenta
- IUD insertion
- Fundus and lochia examination
- Pap test
- Perineal care
- Bishop score
- Vaginal Examination
Introduction
- Maternal mortality in developing countries is often linked to prolonged labor, hemorrhage, infection, obstructed labor, and unsafe abortion.
- A partograph is a chart used to monitor labor progress and identify potential problems like prolonged or obstructed labor and fetal distress.
- The partograph helps track key indicators like cervical dilation, fetal head descent, contractions, and vital signs.
The Partograph
- The partograph is a graphical tool for monitoring labor progress and fetal/maternal well-being.
- Correct use of the partograph is crucial in recognizing abnormal labor and potential distress in the mother or baby.
- The partograph plots key measurements such as fetal heart rate, contractions, and cervical dilation over time.
Identifying Fetal Distress
- Fetal distress is indicated by abnormal fetal heart rate patterns (either constantly low or high).
- The color of amniotic fluid (e.g., meconium-stained) can suggest potential problems.
Finding Your Way Around the Partograph
- The partograph has specific sections for recording time, patient details, and measurements.
- Key measurements like fetal heart rate, uterine contractions, and cervical dilation are recorded on specific parts of the graph.
Cervical Dilation and Descent
- Cervical dilation is measured in centimeters (cm).
- Fetal descent is measured as the station of the presenting part of the fetus relative to the ischial spines.
Moulder and Caput
- Measurements of moulding and caput formation are recorded on the partograph.
- These are indicators that reflect the degree of overlapping or swelling of the fetal skull bones during birth.
- Assessment of moulding and caput is important for evaluating potential disproportion between the maternal pelvis and the fetal head size.
Recording and Interpreting Progress of Labour
- Normal cervical dilatation during active labour progresses at 1 cm per hour, however this differs between multipara's and primiparas'
- Fetal heart rate should be checked every 30 minutes.
- The uterine contractions should be checked every 30 minutes.
Maternal Wellbeing
- Maternal vital signs (blood pressure, pulse, temperature, and urine output) are monitored.
- Abnormal values indicate potential issues that necessitate referral to a higher level facility.
Vaginal and Cervical Examination
- Procedures for performing vaginal/cervical examinations for relevant information about maternal progression and fetal wellbeing.
- Important aspects to note on the examination, such as the status of membranes, the position of the cervix, and the fetus's position and station will all be recorded on the graph.
- The findings are reported on the partograph.
Fetal Heart Rate
- Normal fetal heart rate is typically between 120-160 beats per minute.
- Persistent deviations from this range are cause for concern and may indicate fetal distress.
- Frequent checks are required when the rate falls outside this range.
Amniotic Fluid
- Amniotic fluid assessment is crucial during labor.
- Its clarity and appearance can indicate important aspects of maternal and fetal health.
- Meconium-stained amniotic fluid is cause for concern, requiring immediate referral.
Components of Examination
- The process of placental evaluation and all the observations that need to be made will be recorded.
- The different types of placental characteristics, such as size shape, and completeness of cotyledons.
- The assessment of the umbilical cord, which involves the length, insertion point and presence of knots or thrombi.
- Recording of abnormal observations or other relevant findings for the proper assessment of the mother or fetus
IUD Insertion
- Introduction of an intrauterine device (IUD) to prevent pregnancy.
- Details on contraindications and advantages of using an IUD.
- The procedure outlines for insertion includes detailed preparation, patient positioning, and steps to follow.
Perineal Care
- Perineal care after childbirth focuses on maintaining the health and comfort of the perineal area.
- Cleaning and observation for signs of trauma, infection, or other complications.
Bishop Score
- Bishop score is used to predict likelihood of a successful vaginal delivery in situations where induction may be necessary.
- The score accounts for various factors, including cervical ripening, cervical dilation, consistency, station, and effacement.
Vaginal Examination
- This procedure assesses dilatation, effacement, and station of the cervix, as well as presenting part of the fetus in conjunction with other assessments.
- Indication and contraindications for this examination are explained.
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Description
Test your knowledge on the usage and interpretation of the partograph in obstetrics. This quiz covers key aspects such as fetal heart rate monitoring, cervical dilatation, and the descent of the fetal head. Perfect for medical students and healthcare professionals.