RETURN DEMONSTRATION PERFORMANCE RATING SCALE

LEOPOLD’S MANEUVER/FHT/FHB
Name_____________________ Date________________

Block________________________ Score_________________

Scale/Label Performance Quality Assistance

Independent 5 Has mastery of step and rationale. Needs no direction
Performed proficiently, confidently in
coordinated manner. Appropriate use of
time.
Supervised 4 Has some mastery of step and rationale Requires some direction
performed step proficiently, confidently in
coordinated manner, Appropriate use of
time.
Assisted 3 Forgot to mention and perform the step Requires some direction more often.
and rationale but mentioned later and
correctly performed. Takes long pauses.
Marginal 2 Forgot to mention the step or rationale Requires continuous direction.
and perform the step incorrectly. Spends
considerable amount of time.
Dependent 1 Forgot to mention the step and the Requires redemonstration of
rationale. Incorrect performance of the procedure.
step. Consumed a lot of time.

Procedure 5 4 3 2 1 Remarks
1. Wash hands before the procedure.
2. Identify self to the client.
3. Explain the procedure to the client.
4. The pregnant client empties her bladder.
5. Provide privacy.
6. The client is positioned in dorsal recumbent with one pillow
under the head.
7. Stand facing the client on the right if right-handed (vice-
versa if left-handed.)
8. Observe client’s abdomen for longest diameter and where
fetal movement is apparent.
9. Measure the fundic height of client’s abdomen.
10. Warm hands before the procedure.
11. Facing the client, place both hands flat on the superior
surface of the fundus. Palpate the client’s fundus using the
fingertips.
12. Still facing the client, place the palmar surface of each of
hand on either side of the client’s abdomen. Palpate the
sides of the uterus by holding the left hand stationary on the
left of the uterus, while the right hand palpates the opposite
side of the uterus from top to bottom. Repeats palpation on
the other side using the other hand.
 13. Still facing the client, gently grasps the lower portion of the
abdomen just above the symphysis pubis between the
thumb and index finger.

14. Turn and face the client’s feet. Place fingers on both sides of
the uterus approximately 2 inches above the inguinal
ligaments and press downwards and inwards in the
direction of the birth canal.
15. Place the stethoscope on the client’s abdomen over the
back or chest of the fetus.
16. Differentiate between the fetal heartbeat and other
abdominal sounds (uterine bruit and funic suffle).
17. Listen and count the fetal heartbeat for 1 minute. Note rate
and character of fetal heart tone.
18. Explain to the client the findings of the palpation and
auscultation.
Total= 90 pts. __________________

Signature of Student______________________ Signature of Clinical Instructor__________________