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Questions and Answers

What is the first step to prepare a woman for a physical examination?

  • Provide her with a drape.
  • Ask her to remove all clothing.
  • Position her on the examination couch.
  • Explain the steps of the physical examination and obtain her consent. (correct)
  • Which of the following should be checked to assess the extremities during the examination?

  • Condition of the hair.
  • Strength of the grip.
  • Swelling of the fingers. (correct)
  • Size of the head.
  • How should a woman be positioned during the physical examination?

  • Sitting upright.
  • On her side with knees drawn up.
  • Standing while leaning forward.
  • On her back with knees flexed and slightly separated. (correct)
  • What should be inspected in the abdomen during the examination?

    <p>Scars and hair distribution. (D)</p> Signup and view all the answers

    Which area should be palpated to estimate the period of gestation?

    <p>The abdomen. (B)</p> Signup and view all the answers

    What is the purpose of checking the color of the palms and nails during the extremities examination?

    <p>To check for signs of anemia or cyanosis. (A)</p> Signup and view all the answers

    When preparing for a physical examination, what should the woman do first?

    <p>Empty her bladder. (C)</p> Signup and view all the answers

    What is one indication of possible complications that should be checked during the examination?

    <p>Dilated veins in the legs. (D)</p> Signup and view all the answers

    What position should the nurse discourage the woman from assuming during labor?

    <p>Dorsal recumbent position (B)</p> Signup and view all the answers

    How often should the woman be encouraged to pass urine during labor?

    <p>Every 2-3 hours (B)</p> Signup and view all the answers

    Which of the following is NOT a sign of maternal distress?

    <p>Stable blood pressure (D)</p> Signup and view all the answers

    What can cause retention of urine during labor?

    <p>Lack of muscle tone of the urinary bladder (A)</p> Signup and view all the answers

    What fetal assessment should be performed every 30 minutes after the rupture of membranes?

    <p>Monitor and record fetal heart rate (D)</p> Signup and view all the answers

    Which of the following signs indicate fetal distress?

    <p>Excessive fetal movement (C)</p> Signup and view all the answers

    What is one potential complication related to the power aspect of labor?

    <p>Hypertonic uterine contraction (A)</p> Signup and view all the answers

    What might a full bladder during labor cause?

    <p>Potential vesico-vaginal fistula (A)</p> Signup and view all the answers

    What is the first step in the antenatal assessment process?

    <p>Prepare the client care area and necessary supplies (D)</p> Signup and view all the answers

    Which of the following should NOT be included in preparing the client care area?

    <p>Fingerlings (D)</p> Signup and view all the answers

    What should the healthcare provider do before greeting the client?

    <p>Wash hands with soap and water (D)</p> Signup and view all the answers

    What is an important aspect to communicate to the woman at the beginning of the assessment?

    <p>The importance of regular antenatal visits (B)</p> Signup and view all the answers

    In which scenario would a quick check NOT be performed?

    <p>When the woman has already undergone a quick check (B)</p> Signup and view all the answers

    What should be emphasized to the woman regarding her bladder prior to urine collection?

    <p>Evacuate the bladder (A)</p> Signup and view all the answers

    Which of the following items should NOT be part of the necessary supplies mentioned?

    <p>Notepad and pen (D)</p> Signup and view all the answers

    If the client care area is not comfortable, which of the following actions should be taken?

    <p>Change the furniture arrangement (B)</p> Signup and view all the answers

    What should be assessed regarding the woman's family history during the first visit?

    <p>Family history of diseases such as D.M, hypertension, and cardiac disease (B)</p> Signup and view all the answers

    Which daily habits should be inquired about during the first visit?

    <p>Her eating habits and exposure to harmful substances (C)</p> Signup and view all the answers

    What specific information about previous pregnancies should be collected?

    <p>Length, outcome, and any complications of previous pregnancies (B)</p> Signup and view all the answers

    What is the first step when performing a urine analysis for sugar and albumin?

    <p>Explain the steps in the procedure and obtain consent (D)</p> Signup and view all the answers

    What detail concerning previous childbirths is important to document?

    <p>Number, sex, and weight of each newborn (A)</p> Signup and view all the answers

    What should be done if a woman's hemoglobin level is less than 7 g/dl?

    <p>Refer her to a specialist (A)</p> Signup and view all the answers

    Which of the following tests is routinely performed during prenatal visits?

    <p>Urine or blood test for pregnancy (C)</p> Signup and view all the answers

    What aspect of postpartum history is important to discuss?

    <p>Contraceptive history and any complications experienced (D)</p> Signup and view all the answers

    What menstrual history should be reviewed during the first visit?

    <p>Duration of menstrual flow and any associated problems (A)</p> Signup and view all the answers

    What action should be taken after removing gloves?

    <p>Turn gloves inside out before disposal (A)</p> Signup and view all the answers

    What critical information about her last menstrual period (LMP) should be asked?

    <p>First day of LMP to calculate the expected date of delivery (EDD) (B)</p> Signup and view all the answers

    What is the purpose of a non-stress test during pregnancy?

    <p>To check the baby's heart rate when the baby moves (C)</p> Signup and view all the answers

    Which routine test is specifically done around 28 weeks of pregnancy?

    <p>Blood test for diabetes (B)</p> Signup and view all the answers

    Which question should be asked regarding future family planning?

    <p>How many more children she plans to have (A)</p> Signup and view all the answers

    What should be done after recording findings from a woman's examination?

    <p>Discuss the findings with her (B)</p> Signup and view all the answers

    What is indicated for a woman with a negative Rh factor result?

    <p>She requires anti-D immune globulin (B)</p> Signup and view all the answers

    What should be done after the procedure when utilizing a partograph?

    <p>Clean, repack, and sterilize all the used equipment. (A)</p> Signup and view all the answers

    At what cervical dilation should a multiparous woman be transferred to the delivery room?

    <p>When the cervix is 8-9 cm dilated. (C)</p> Signup and view all the answers

    What should be assessed before performing a vaginal examination?

    <p>Whether the patient has emptied her bladder. (A)</p> Signup and view all the answers

    Which action is necessary to gain the patient's cooperation during the examination?

    <p>Tell her in terms she understands what you will be doing. (A)</p> Signup and view all the answers

    Which step should be performed simultaneously with asking the patient to lie on her back?

    <p>Perform the abdominal examination. (D)</p> Signup and view all the answers

    What is the first step in preparing for a vaginal examination?

    <p>Prepare the necessary equipment. (A)</p> Signup and view all the answers

    How should the labia be cleaned during the examination?

    <p>Use five swabs, one for each part. (D)</p> Signup and view all the answers

    Which rating indicates that a step in the procedure needs improvement?

    <p>Needs Improvement. (B)</p> Signup and view all the answers

    Flashcards

    Proficiently Performed

    A step or task is done accurately, precisely, and in the correct sequence.

    Preparing the Client Area

    Setting up the clinic space with all needed supplies and equipment for the client (e.g., stethoscope, thermometer, scales).

    Hand Hygiene

    Cleaning hands with antiseptic rub or soap and water prior to patient contact.

    Welcoming the Client

    Greeting the woman and her companion with respect and kindness, offering a seat, introducing yourself, and explaining the procedure.

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    Client Explanation

    Explaining the antenatal visit's purpose, schedule, and components to the woman.

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    Quick Check Confirmation

    Verifying if a quick check for the woman has been previously performed and acting accordingly. This could include conducting the quick check if it has not been done.

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    Urine Specimen Collection

    Instructing the woman to provide a urine sample.

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    Flexibility in Questioning

    Being adaptable in the order you ask questions during a patient interview.

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    Family History Inquiry

    Asking the woman about her family history of diseases like diabetes, high blood pressure, heart disease, multiple pregnancies, birth defects, and allergies (like asthma or eczema). This includes specifying the relationship and the disease.

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    Lifestyle & Habits Inquiry

    Questions about physical activity (walking, heavy lifting, labor), sleep, diet (including non-food substances), exposure to pregnancy hazards (caffeine, tobacco, drugs, harmful substances), violence, over-the-counter medications, and toxin/chemical exposure.

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    Previous Pregnancies Inquiry

    Detailed questions about previous pregnancies, including length, outcomes (live births, miscarriages, abortions), problems during pregnancy (like seizures), and dates of past abortions.

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    Previous Childbirths Inquiry

    Detailed questioning about past deliveries, including number, sex, birth weight, premature births (preterm), low birth weight (LBW), stillbirths, childbirth problems (like C-sections, uterine surgery, tears), and more.

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    Postpartum History Inquiry

    Questions about contraceptive use after childbirth, complications during the postpartum period (like postpartum hemorrhage or PPH), breastfeeding (duration and any problems like cracked nipples or mastitis).

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    Menstrual History Inquiry

    Questions about the woman's menstrual cycle (menarche age, flow duration, interval, amount, problems).

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    Contraceptive History Inquiry

    Questions about past and current use of family planning methods.

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    Expected Delivery Date Calculation

    Determining the estimated date of delivery (EDD) by using the information of the first day of the last menstrual period (LMP).

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    Bartholin's Gland Exam

    Check Bartholin's glands for discharge and tenderness by inserting index finger into vagina and palpating each side of labia majora for swelling or tenderness.

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    Perineum Inspection

    Check perineum for scars, lesions, inflammation or cracks in skin.

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    Extremity Exam

    Check the color of palms and nails, swelling of fingers, shape and length of legs, ankles, and feet, and edema over tibia, ankle and feet. Observe for dilated veins.

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    Danger Signs of Pregnancy

    Check for indications of potential dangers during pregnancy.

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    Fundal Height Measurement

    Palpate the abdomen to estimate gestational age by measuring the distance from the xiphoid process to the fundus.

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    Abdominal Inspection

    Inspect the abdomen for scars, hair distribution, skin pigmentation, edema, fetal movement, and enlargement.

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    Fundal Palpation

    Palpate the uterine fundus to estimate gestational age. Stand on the woman's right side.

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    Preparing for Exam (Consent)

    Explain examination steps and obtain woman's consent; empty bladder; may collect urine; have woman undress appropriately; position on exam table; drape.

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    Urine Analysis for Sugar and Albumin

    A laboratory test performed to detect the presence of sugar and albumin in urine.

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    Hemoglobin Test

    A blood test measuring the amount of hemoglobin in the blood, used for prenatal care.

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    Blood Group and Rh Test

    A blood test to determine the woman's blood type and Rh factor.

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    Anti-D Immune Globulin

    A medication given to Rh-negative women to prevent hemolytic disease of the newborn.

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    Prenatal Visits

    Regular medical checkups during pregnancy.

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    Amniocentesis

    A prenatal test where fluid from the amniotic sac is sampled to test for certain conditions.

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    Urine sample collection

    Collecting a urine sample from a woman for lab analysis during pregnancy.

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    Optional Prenatal Tests

    Tests not routinely performed during prenatal care, done only when medically indicated.

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    Partograph Uses

    The partograph records and tracks labor progress, helping to monitor potential complications in both mother and baby.

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    Maternal/Fetal Complications Reporting

    Report any issues observed during the procedure.

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    Equipment Sterilization

    Cleaning and sterilizing used equipment to prevent infection.

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    Stock Return

    Ensure that all supplied items are returned to their designated location or stockroom.

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    Primiparous Transfer

    Transfer the patient to the delivery room when the presenting part is pushing on the perineum of the mother.

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    Multiparous Transfer

    Transfer the patient to the delivery room when cervix is 8-9 cm dilated.

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    Vaginal Exam Equipment Prep

    Gather all necessary items for vaginal exam: gloves, lubricant, sterile pads.

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    Patient Bladder Emptying

    Instruct the patient to urinate before vaginal exam.

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    Labor Positions

    Woman in labor should be allowed to choose a comfortable position, EXCEPT for lying on back (dorsal recumbent) which can cause low blood pressure and harm baby .

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    Bladder Care in Labor

    Encourage woman to urinate every 2-3 hours during labor. A full bladder can cause poor contractions, bleeding, and possible injury.

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    Maternal Distress

    Signs of serious problems in mother include fast pulse, high temperature, low blood pressure, sweating, pale face, dehydration, unusual vomit, ketones in urine, or mood changes.

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    Fetal Distress Signs

    Unusual fetal movement, head squeezing, extra fluid at head, heart rate over 160 or under 100, irregular heart rate, or poop in amniotic fluid (for head-first babies) are all problems.

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    Fetal Assessment Frequency

    Fetal heart rate should be routinely monitored. Before water breaks, every 4 hours. After, every 30 minutes.

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    Hypotonic Contractions

    Weaker than normal uterine contractions don't push baby out effectively. Often a sign of a labor issue.

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    Cephalopelvic Disproportion (CPD)

    Baby's head is too big for mother's pelvis, requiring special care during labor.

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    Fetal Distress

    Baby is in danger before birth and has a problem that causes a change in heart rate, unusual movements or other signals.

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    Study Notes

    Manual of Maternity and Newborn Health Nursing

    • This is a manual for maternity and newborn health nursing, created by maternity and newborn health nursing staff members.
    • It includes revision edition, clinical learning guides, and checklists to facilitate learning and assessment of core competencies.
    • The document was produced by a Health Workforce Development (HWD) Project sponsored by the United States Agency for International Development and the United States Government.

    Introduction

    • Clinical Learning Guides (CLGs) and Clinical Skill Checklists (CCLs) are internationally accepted best practices adapted to the Egyptian context, assisting clinical skill acquisition and assessment of clinical competency.
    • CLGs provide step-by-step descriptions of skills. CCLs are used for learner assessment, derived from the CLGs.
    • CLGs are effective because they align with adult learning theories, including using behavior modeling, and are inherently competency-based.
    • These tools promote peer-to-peer and self-learning.
    • They are used in simulation environments (such as skill labs) and clinical practice.
    • The revised core curricula in obstetrics and gynecology, pediatrics, and community health are consistent with CLGs and CCLs, alongside those used in nursing programs.
    • The HWD project has developed a model for instructional materials design and development, offering standardized materials suitable for use in Egypt.

    Contents

    • The document lists learning guides for various topics, including antenatal assessment, fetal heart rate, labor management and assessment, perineal care, newborn assessment, and more.
    • Specific learning guides outline the steps and important tasks in each process.

    Learning Guide 1: Antenatal Assessment

    • This guide details step-by-step clinical procedures for antenatal assessment, including physical examinations, history, and testing.
    • Provides a rating scale (1-4) for evaluating participant performance.
    • Includes information on getting ready, preparation tasks (preparing equipment, care area, client, etc.).
    • There are detailed checklists for different aspects of patient history and examination.

    Learning Guide 2: Auscultation of Fetal Heart Rate

    • Explains the steps for fetal heart rate assessment.
    • Outlines how to position the client, prepare supplies, perform assessments, and record results.
    • Offers a rating scale to measure participant efficiency.

    Learning Guide 3: Pitting Edema Assessment

    • Explains the steps for assessing pitting edema.
    • Discusses how to prepare for the examination, including observation and evaluation.

    Learning Guide 4: Deep Tendon Reflex Assessment

    • Explains procedures for assessment of Deep Tendon Reflexes.
    • Includes a detailed step-by-step guide, preparation steps (equipment preparation, client positioning and reassurance), testing techniques, and a rating scale for assessments.

    Learning Guide 7: Management of First Stage of Labor

    • Details the comprehensive steps for handling first stage labor management.
    • Focuses on preparedness (equipment), nursing assessments (medical history, vital signs, progression of labor), nourishment and hydration, rest and sleep, pain management, preventing infections and infection control measures.

    Learning Guide 8: Vaginal Examination During Labor

    • Provides a step-by-step guide for vaginal examinations during labor.
    • Instructions include preparation steps, assessment steps, and post-procedure tasks.

    Learning Guide 11: The Partogram

    • Provides a step-by-step guide on how to properly use and complete a partogram. Key components to fill during the first, second, third, and post-procedure tasks are mentioned.

    Learning Guide 12: Management of Second Stage of Labor

    • Includes a breakdown of management steps for the second stage of labor.

    Learning Guide 13: Instrumental tray of normal labor

    • Details the contents of and procedure for the appropriate preparation of an instrumental tray used for normal labor.

    Learning Guide 14: Perineal Care

    • Contains detailed steps for perineal care including, preparation (equipment), assessment, and postpartum tasks.

    Learning Guide 15: Episiotomy

    • Provides procedures for episiotomy, including preparation (equipment preparation), assessment steps (infiltrate the local anesthesia and allowing time for anesthesia to become effective), steps to perform the incision, post-operative tasks.

    Learning Guide 16: Management of Third Stage Labor

    • Covers management of the third stage of labor, including preparation, assessment, and postpartum procedure tasks.

    Learning Guide 17: Examination of the Placenta

    • Offers procedures for examining the placenta during labor management.

    Learning Guide 18: Newborn Assessment

    • Details the procedures for newborn assessment, covering preparedness (equipment preparation), assessment steps (physical assessment, and neuromuscular maturity assessment methods like using Ballard scales, checking for signs, measuring vital signs such as temperature, respiration and more), and post-procedure tasks.

    Learning Guide 19: Immediate Care of the Newborn

    • Outlines immediate care steps for newborn after birth, including identifying, securing the infant's safety, positioning and monitoring, cord and eye care, and assessing for any complications.

    Learning Guide 20: Neonatal Resuscitation

    • Explains methods and procedures for neonatal resuscitation, including preparation steps and procedures.

    Learning Guide 21: Management Of Fourth Stage Of Labor

    • Includes details on managing fourth stage of labor and includes the evaluation of uterine tonicity, observation of lochia, assessment for complications (like bleeding), comfort measures (intake and output) and post-procedure tasks.

    Learning Guide 22: Fundus And Lochia Assessment

    • Details the steps for assessing the fundus and lochia after childbirth and the steps required for the postpartum evaluation.

    Learning Guide 23: Perineal Care & Assessment

    • Contains steps for performing perineal care and assessment after childbirth.

    Learning Guide 24: Routine Episiotomy Care

    • Provides routine episiotomy care procedures, and health education for postpartum women.

    Learning Guide 25: Routine Neonatal Care (First Two Weeks)

    • Outlines the care process for newborns during the first two weeks following birth.

    Learning Guide 26: Nursing Responsibilities In Various Gynecological Examination In Gynecological Clinic

    • This guide details the preparation for and during various gynecological examinations, including patient preparation, equipment, and post-procedure tasks.

    Learning Guide 27: Breast Examination

    • Includes steps for performing breast examinations and important tasks (such as history taking, identifying possible risk factors, preparing the equipment and patient, and performing the examination).

    Learning Guide 28: Assisting in IUD Insertion

    • Details the steps in guiding a patient through the insertion of an Intrauterine Device (IUD).

    Learning Guide 29: Administration Of Contraceptive Hormonal Injection

    • Covers the preparation and administration of hormonal contraceptive injections, emphasizing proper injection procedures, safety measures, and documentation.

    Learning Guide 30: Assisting In Insertion And Removal Of Norplant Implants

    • Provides detailed steps for assisting in the insertion and removal of Norplant implants, covering preparation, procedure, post-procedure tasks.

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