Vaginal Examination During Labor PDF

Vaginal Examination during Labor by dr/Treza Saber  :Introduction A vaginal examination is an assessment skill that takes time and experience to develop, only by doing it frequently in clinical practice can.the practitioner's skill level improve  :Definition It is the...

Vaginal Examination during Labor by dr/Treza Saber  :Introduction A vaginal examination is an assessment skill that takes time and experience to develop, only by doing it frequently in clinical practice can.the practitioner's skill level improve  :Definition It is the examination done per vagina to detect the status of the vagina and cervix, and to assess the progress of labors as the fetal presenting part descends through.the birth canal  :Objectives The purpose of performing a vaginal -:examination is To make a positive diagnosis of labor.1 To monitor cervical dilatation and.2.effacement To make a positive identification of the fetal.3.presentation To ascertain whether fore-water have.4 ruptured To determine if cord prolapsed is likely to.5.occur To gather information on station,.6 degree of fetal head flexion and presence of fetal skull swelling or molding allow the baby's head to change( )shape To assess the progress or delay in.7.labor  Equipment :A sterile tray containing.Sterile cotton balls to give care.1.Artery clamp.2.Bowl with antiseptic solution.3 Sterile cream in a bowl for.4.lubrication.Sterile gloves (outside the tray).5  General Instructions (preliminary assessment) 1-A vaginal examination shall only be carried out if it will benefit the mother management and care. All vaginal examinations shall be-2.preceded by an abdominal palpation It should be restricted or limited-3.after membranes has ruptured 4-It should be avoided in case of ante partum hemorrhage. Verbal consent shall always be-5 obtained and treated with dignity.and respect at all times Hand hygiene should be performed-6 before and after the examination and Gloves should be worn on both hands Procedure Rationale Nursing action.Promotes compliance.Explain procedure to mother.1 Avoids discomfort during Ask mother to void if the.2.procedure.bladder is not empty For smooth and safe Explain how she should relax.3.performance of the procedure.during the examination. For good visualization Position the women in.4 dorsal recumbent position with knees flexed and legs.apart outwards. Provides privacy.Drape the patient.5 Prevents spread of infection Do a surgical hand washing.6 from hands to the mother and.& done sterile gloves.fetus To detect any abnormalities Separate the labia with your gloved.7 before procedure fingers. Observe the general area of :Vaginal opening for Amount of bloody show- Deep yellow or greenish-.brown discharge Signs of inflammation or- infection -.Observe for vulval edema Any scars indicating- Lubricates the fingers. Lubricate the index.8 and middle fingers of.your examining hand To gives some control Ask the patient if you.9.and empowering may proceed now To reach for cervix Move your fingers the.10 full length of the vagina.(usually 7.5-8)  Before insertion.11 should not touch keep the thumb the rectal area straight up and stretched out and Keep the fourth and fifth fingers bent inward and touching.the palm of your hand :Note the following.State of the vagina- State of cervix,- effacement, and.dilatation.Membranes-.Presenting part- Position, station and-.engagement.Degree of moulding-  Post procedure tasks 1-Swab the vulva orifice to dry it in the reverse order (with vaginal opening then the vestibule and finishing with labia majora). If the membranes have ruptured-2.place a sterile pad over the vulva Turn the patient on to her left side,-3 dry the anal region and pull through the sanitary towel. You may change.the bed linen.Make patient comfortable-4