Orientation on

Maternity Knowledge,
Skills and Logbook
Instructions
AL GHAD INTERNATIONAL COLLEGE FOR MEDICAL SCIENCES, FEMALE CAMPUS
BURAYDAH, AL QASSIM, KSA
Topics:
 Orientation on Maternity Knowledge, Skills and Logbook Instructions Guidelines
 Assessment On Pregnant Women, Léopold’s Maneuver
 How to count Fetal Heart Tone, Baby Kick Count, Monitoring Stages of Labor
 Admission and Discharge, How to write Nurse’s Notes
 Drug Calculations
 Newborn Care, Phototherapy
 Post-Partum Care, Perineal Care and Hot Sitz Bath
 Importance of Breastfeeding and comparison of Bottle Feeding
 How to Sterilize Feeding Bottle
 Uses of Contraceptive Method as a Guide in Family Planning
 Importance in Understanding Laboratory Investigations and Imaging
 How to operate CTG, Doppler and Ultrasound Machine
 Post Laboratory Examinations
Assessments: An examinations from head to toe
Present/Past History:
Serious illnesses
 Menarche, Interval of Menstruation
 Length Any Hospitalizations
 Recent birth control or lactation Any Surgery
 LMP -Sure of date? Drug allergies or unusual reactions
- Normal in length & flow What are the Medication taken since LMP
 Other signs and symptoms:
 Date of conception
 ER sonogram

Obstetrical History: Gynecological History:

 Dates of all pregnancies (include previous  Last Pap
miscarriage or termination)  Abnormal pap
 GA  Gyn surgery or problems (e.g.
 Gender, weight infertility)
 Length of labor  Family planning methods
 Coping techniques  Sexually transmitted infections
 Route of delivery
 Special events AP, IP, PP, Neo
 Family History
Maternal Maternal or Paternal
 Diabetes  Birth defects
 CAD
 Mental retardation
 Pre-eclampsia
 Bleeding disorders
 Preterm delivery
 Chromosomal abnormalities
 Cancers (breast, ovarian, colon)
(e.g. Dpwn Syndrome)
 Depression, bipolarity
 Twins
 Anesthesia reactions
Prenatal Care:
 What are the vital signs?
-Temperature, Pulse Rate, Respiratory Rate, BP
-Koilonychia Spoon-shaped nails, a Chronic
 What are the measurement of the Patient? iron deficiency anemia
-Height -Weight
-Cyanosis of nail beds
 Any Observations?
-Clubbing – caused by chronic hypoxia

-HEENT – Lymph Nodes

-The mouth (B vitamin deficiency, Fungal infections
and Over-biting, Gingivitis of pregnancy
-Geographic tongue

-Lines coincide with periods of acute illness or

stress. Caused by disruption of nail -Superficial Nasal Sinuses
plate growth.

-Eyes
Cont.
-Chalazion (plugged sebaceous gland) -Auscultation of the lungs
-Conjunctivitis – viral *Normal breath sounds, Crackles,

Rhonchi, Wheezes
-The eyes – icterus
- Abdominal assessment
-The Neck:
-Inspect abdomen for contour, asymmetry,
1. thyroid (watch for any s/s:) scars, rashes, or other lesions
a. Hypothyroid -Listen for bowel sounds present, increased,
decreased, absent, high-pitched
-Cold intolerance, slow pulse, thin, dry hair &
-Light palpation for tenderness most sensitive
dry, puffy skin, Fatigue, thick tongue,
indicator is facial expression, voluntary or
delayed relaxation of Achilles reflex involuntary guarding may also be present
b. Hyperthyroid -Deep palpation for masses

-Heat intolerance, Rapid pulse, -Deep tendon reflexes and check for edema

Flushed, sweating, Anxious,

Fine tremors, Exaggerated reflexes
-The Chest, Breast and the cardiac cycle
-The Back
Leopold’s Maneuver:
-First Maneuver: Fundal Grip
a. Use the pads of your fingers of
your both hands to feel and
palpate lightly the fetal part lying
in the fundus to determine
presentation.
b. Push a little to identify fetal lie.
Cephalic or Head -is more firm, hard
and round that moves independently
of the body.
Breech -is less well defined that
moves only in conjunction with the
body.
Third Maneuver: Pawlik Grip
a. Encouraged patient to perform breathing
exercise during palpation. Placed your right
hand, above the symphysis pubis with the thumb
and four fingers to grasp the lower portion of the
abdomen.
b. Slightly press and make a gentle movements
from side to side to identify the presenting part if
it is engaged or not and the degree of descent
in the pelvic canal.
Engagement- presenting part is not movable.
Floating- still movable.
-Second Maneuver: Umbilical Grip
a. Remain facing the patient’s head.
Place both palms on the side of the
abdomen at the level of the
umbilicus.
b. Use gentle but deep pressure on
palpating the opposite side of the
abdomen alternately to determine the
location of the fetal back and small
fetal parts that occupying the side wall
of the uterus.
Fetal Back -is felt as firm, smooth and
resistance surface.
Fetal Limbs–are felt as small, irregular, mobile
and slippery knobs or nodules.(These
are the knees and elbows)
Fourth Maneuver: Pelvic Grip
a. Face the patient’s foot part.
b. The two hands are placed on the lower part of
the uterus.
c. Gently move your fingertips down the sides of
the abdomen towards the pelvic brim, 2
inches above the inguinal ligament, and determine
the position and the flexion of the presenting part.
Good attitude- if brow correspond to the side
(Second Maneuver) that contained the elbows and
knees.
Poor attitude- if examining fingers will meet an
obstruction on the same side as fetal back
(hyperextended head).
d. Auscultate the fetal heart sound and compare it
with Maternal Heart Sound within 1 full minute.
Counting a Fetal Heart Tone:
Baby Kick Count:
Knowing Stages of Labor and Delivery Complications
How to Admit and Discharge Patient?
 Caring for Newly Born Baby
 Suctioning the secretion
 Keeping warm
 Bathing
 Taking a anthrometric measurement
 Foot prints and ID band
 Immunization
 Feeding
 Bonding
Significant of Phototherapy?
Newborn Screening
Post partum Care
Perineal Care and Hot Sitz Bath
Writing a Nurse’s Notes an Easiest Way?
Writing a Nurse’s Notes an Easiest Way?
Writing a Nurse’s Notes an Easiest Way?
How to compute drugs and IV fluids?
Importance of Breastfeeding and comparison of Bottle Feeding
How to Sterilize Feeding Bottle
Uses of Contraceptive Method as a Guide in
Family Planning?
How to Operate a CTG Machine, Doppler, Jaundice
Machine and Ultrasound
 Film Showing?
 The Joy of Birth
 Cesareans Section
 Apgar Scoring
 Breast Self Examination
 Circumcisions
Understanding Laboratory Investigation and Imaging
Post Laboratory Examinations
Thank You for Listening
and not Sleeping in my
class!