Leopold's Maneuver Assessment PDF

LEOPOLD’S MANEUVER CHN RLE 1ST ROTATION ORLANDO ASSESSMENT OF LEOPOLD’S MANEUVER INTRODUCTION...

LEOPOLD’S MANEUVER CHN RLE 1ST ROTATION ORLANDO ASSESSMENT OF LEOPOLD’S MANEUVER INTRODUCTION Fetal head Hard, round mass, ballotable Transverse lie Upper part is empty 1. Explain procedure to the client. Good day, ma’am! I am Maxime, your student nurse for today. I’ll be performing Leopold’s maneuver to check the fetal position and 2ND MANEUVER (LATERAL OR UMBILICAL GRIP) orientation, ensuring a safety delivery. 9. Place the palms of each hand on either of the For this procedure, we’ll be using an abdomen. I will now face you to perform the second examination table for your comfort, maneuver. a basin for hand hygiene, a tape measure to assess the fundal The second maneuver helps assess the shape height, and position of the uterus, identify the fetal lie, and evaluate uterine tone by palpating the sides a rolled towel for proper visualization, of the uterus. and a blanket to maintain your privacy 10. Palpates the sides of the uterus. 2. Instructs the client to empty her bladder. The the sides Ma’am may I ask to empty your bladder to enhance your comfort and accuracy during 11. Holds the left hand stationary on the left side of the assessment. uterus while the right hand palpates the opposite side of the uterus from top to bottom. 3. Positions the client supine, knees slightly flexed with a 12. Hold the right hand steady. small pillow or rolled towel under one side. Ask permission first 13. Repeats palpation using the left hand on the left side. To prevent supine hypotension syndrome The uterus is well-defined, with the fetal back smooth, limbs irregular, and the fetus potentially 1ST MANEUVER (FUNDAL GRIP) in a transverse lie with the head or breech palpable on one side. 4. Wash hands using warm water. Perform Hand Hygiene 3RD MANEUVER (PAWLIK’S GRIP) 5. Observes the woman's abdomen for the longest diameter and where fetal movement is apparent. The third maneuver assesses the fetal position The longest diameter of the abdomen, measured and engagement by feeling the firmness and at approximately 36 inches from the fundus to the consistency of the presenting part in the lower symphysis pubis, is observed, and areas of fetal abdomen. movement are noted where kicks and rolls are more apparent. 14. Facing the client, gently grasps the lower portion of the abdomen just above the symphysis pubis 6. Place both hands on her abdomen. between the thumb and index finger and tries to press I will now place both of my hands on your the thumb and finger together. abdomen to begin the examination The lower portion of the abdomen feels firm when grasped between the thumb and index finger, 7. Palpates the superior surface of the fundus. indicating the fetal presenting part. The superior surface of the fundus is at the expected level for the gestational age, indicating 15. Determines any movement and whether the part is normal fetal growth and positioning. firm or soft. The presenting part is firm with minimal 8. Determines mobility, shape and consistency. movement, suggesting it is engaged and in a The fundus is found to be firm with a round shape stable position. and good mobility, indicating a normal uterine tone and fetal position Fetal buttocks Soft, irregular, immovable mass CABAMONGAN, MAXIME KELLY JULIAN B, | BSN-II ORLANDO 1  MAXIMUS 4TH MANEUVER (PELVIS GRIP) The rationale is to assess fetal attitude and how well the presenting part is engaged in the pelvis. 16. Facing the foot part of the client, places fingers on both sides of the uterus approximately 2 inches above the inguinal ligaments, pressing downward and inward in the direction of the birth canal 17. Allows fingers to be carried downward. The normal finding is a good attitude because it indicates that the fetal presenting part is properly engaged and descending into the birth canal, reflecting an optimal position for labor. AFTER CARE Thank you for your cooperation during the examination. I will now perform hand hygiene and ensure that all equipment is properly cleaned and put away. NOTE: HAND ALWAYS CLOSE ALWAYS DO HAND HYGIENE CABAMONGAN, MAXIME KELLY JULIAN B, | BSN-II ORLANDO 2