‫ﺪ‬

‫ﻴ‬‫ﻟ‬‫ﻮ‬
‫ﺘ‬‫ﻟ‬‫ﺍ‬
‫ﺀﻭ‬‫ﺎ‬
‫ﻨﺴ‬‫ﻟ‬
‫ﺍ ﺽﺍ‬
‫ﺮ‬‫ﻣ‬‫ﻳ ﺾﺃ‬
‫ﺮ‬‫ﻤ‬‫ﻗﺴﻢﺗ‬

Studentacti
viti
eslogbook
Of
Pr
act
icaltr
aini
ngf orObstetr
icsand
Gynecol
ogicalNursing
for
Thi
rdyearstudent
s
2021/2022
Super
visor

Chai
rmanofDepar
tment
Dr
/Sami
aAbdel
-Hakeem Hassanen
Pr
of.ofObst
etr
ics&Gy
necol
ogi
cal
nur
sing
Depar
tmentst
aff
Pr of
.Dr /Sami aAbdel -
Hakim Dr .FatmaKamal
Prof.Dr /SoadAbdEl Sal
am Dr .
OlaAbdEl Wahab
Prof.
Dr /Amal AhmedHassan Dr.Zai nabRabea
Assist.pr of .HendAbdAl l
ah Dr .Mai Mahmoud
Assist.prof.SamahAbdEl Hali
m Dr.AsmaaAbdel -r
azek
Assist.prof .Emanabdel -Hakam Dr .
GehadGamal
Assi st.pr of .Somay aOda Assist.L.AmanyAhmed
Assi st.pr of .AfafEmam Assist.
L. AzizaEl-
saadawy
Assist.prof .HematMust af
a Assist.L.Sal maHussei
n
Assist.pr of .Ami raSalama Assist.L. NesmaAbdel -
Aziz
Assi st.prof .Rehabsol i
man Demonst .
SaharShafek
Assi st.prof .El ham Abuzaid Demonst .AmalSaad
I
 Dr
.HananAmi
n Demonst
.Zai
nabBasem

Demonst.
HendMohamed Demonst
.YomnaMohamed

I
I
 ‫ﺪ‬
‫ﻴ‬‫ﻟ‬‫ﻮ‬
‫ﺘ‬‫ﻟ‬‫ﺍ‬
‫ﺀﻭ‬‫ﺎ‬
‫ﻨﺴ‬‫ﻟ‬
‫ﺍ ﺽﺍ‬
‫ﺮ‬‫ﻣ‬‫ﻳ ﺾﺃ‬
‫ﺮ‬‫ﻤ‬‫ﻗﺴﻢﺗ‬

St
udentpi
ctur
e

Hospital'
sName:
…………………………………………………………
Student'sName:
…………………………………………………………
I
nstructorSign.:
…………………………………………………………
SupervisorSign.:
…………………………………………………………
ChairmanofDepar t
ment
: Dr.
Sami
aAbdel
-Haki
m Hassanen

I
II
Pr
eface:
-
Thi
sstudentl
ogbookhasbeendev elopedforthir
d
y
earstudentsatObstetr
icsandgynecological
nur
sing
t
oenablet hem t
of ol
low cour
secontent sandt ime
t
abl
eforeachacti
vit
y,eventandworkgroup.

Thepurposeofthisl
ogbookistoprovide thestudent
witht
heknowl edgeandpracti
calskil
ls thatneeded
taket
hedeci si
ons t
osolveanypr oblems regarding
theObstetr
icandGynecol
ogi
calNur si
ng.

Eachst
udentwi
llbeabletoknowclini
calgroup,
supervi
sor,staf
fandtutori
alsuppor
t.when,wher e
andbywhom eachact i
vi
t i
eswillbedonealloverthe
academicwork.

Any queries r
egardi
ng t
hislog book please
cont
acttutor
ialsuppor
tasiti
sclear
lyi
denti
fi
edi
nt hi
s
l
ogbookf oreachgroup.

Dr.
SamiaAbdel-Hakeem Hassanen
Pr
of.ofObst
etr
ics&Gy necol
ogicalnur
sing
Chairmanofdepar tment
Januar
y,2021/
2022
I
V
V
 ‫ﺀﻭ‬
‫ﺎ‬‫ﻨﺴ‬
‫ﻟ‬‫ﺍ ﺽﺍ‬
‫ﺮ‬‫ﻣ‬‫ﺍ‬
‫ﻳﺾ‬ ‫ﺮ‬‫ﻤ‬‫ﺔﻗﺴﻢﺗ‬
‫ﻳ‬‫ﺅ‬‫ﺭ‬
‫ﺪ‬‫ﻴ‬
‫ﻟ‬‫ﻮ‬‫ﺘ‬
‫ﻟ‬‫ﺍ‬

‫ﺓ‬
‫ﺰ‬‫ﻴ‬‫ﻤ‬
‫ﺘ‬‫ﻤ‬‫ﻟ‬
‫ﺔﺍ‬‫ﻴ‬
‫ﻤ‬‫ﻠ‬‫ﻌ‬
‫ﻟ‬‫ﺎﻡﺍ‬
‫ﻗﺴ‬‫ﻮﻥﻣﻦﺍﻻ‬
‫ﻜ‬‫ﻠﻲﺃﻥﻳ‬
‫ﺪﻋ‬‫ﻴ‬
‫ﻟ‬‫ﻮ‬‫ﺘ‬
‫ﻟ‬‫ﺍ‬
‫ﺀﻭ‬‫ﺎ‬
‫ﻨﺴ‬‫ﻟ‬
‫ﺍ ﺽﺍ‬
‫ﺮ‬‫ﻣ‬‫ﻳ ﺾﺃ‬
‫ﺮ‬‫ﻤ‬‫ﻌﻲﻗﺴﻢﺗ‬
‫ﻳﺴ‬
‫ﻳﺾ‬
‫ﺮ‬‫ﻤ‬‫ﺘ‬
‫ﻟ‬‫ﺎﺕﺍ‬
‫ﻴ‬‫ﻠ‬
‫ﻜ‬‫ﺪﺑ‬
‫ﻴ‬‫ﻟ‬‫ﻮ‬
‫ﺘ‬‫ﻟ‬‫ﺍ‬
‫ﺀﻭ‬‫ﺎ‬
‫ﻨﺴ‬‫ﻟ‬
‫ﻳ ﺾﺍ‬
‫ﺮ‬‫ﻤ‬‫ﻡﺗ‬
‫ﺎ‬‫ﻗﺴ‬
‫ﻊﺃ‬‫ﻴ‬
‫ﻤ‬‫ﻮﻯ ﺟ‬
‫ﺘ‬‫ﻠﻰﻣﺴ‬
‫ﺎﻋ‬‫ﻳ‬
‫ﺭ‬‫ﺎ‬
‫ﻬ‬‫ﻣ‬‫ﺎﻭ‬
‫ﻴ‬‫ﻤ‬‫ﻠ‬
‫ﻋ‬
‫ﺓ‬
‫ﺀ‬‫ﺎ‬‫ﻔ‬
‫ﻜ‬‫ﺓﺑ‬
‫ﺃ‬‫ﺮ‬‫ﻤ‬
‫ﻟ‬‫ﺔﺍ‬
‫ﺔﺑﺼﺤ‬
‫ﻴ‬‫ﻳﻀ‬
‫ﺮ‬‫ﻤ‬‫ﺘ‬
‫ﻟ‬‫ﺔﺍ‬
‫ﻳ‬‫ﺎ‬‫ﺮﻋ‬
‫ﻟ‬‫ﻳﻢﺍ‬
‫ﺪ‬‫ﻘ‬‫ﺔﻓﻰﺗ‬
‫ﻴ‬‫ﺑ‬‫ﺮ‬
‫ﻌ‬‫ﻟ‬‫ﺮﺍ‬
‫ﺔﻣﺼ‬
‫ﻳ‬‫ﺭ‬‫ﻮ‬
‫ﻬ‬‫ﻤ‬‫ﺓﺑﺠ‬
‫ﺮ‬‫ﺎﻇ‬
‫ﻨ‬‫ﻤ‬
‫ﻟ‬‫ﺍ‬
‫‪.‬‬
‫ﺔ‬‫ﻴ‬‫ﻟ‬
‫ﺎ‬
‫ﺓﻋ‬‫ﺩ‬
‫ﻮ‬‫ﻭﺟ‬

‫ﺀﻭ‬
‫ﺎ‬‫ﻨﺴ‬
‫ﻟ‬‫ﺍ ﺽﺍ‬
‫ﺮ‬‫ﻣ‬‫ﻳ ﺾﺍ‬
‫ﺮ‬‫ﻤ‬‫ﺔﻗﺴﻢﺗ‬
‫ﻟ‬‫ﺎ‬
‫ﺭﺳ‬
‫ﺪ‬‫ﻴ‬‫ﻟ‬
‫ﻮ‬‫ﺘ‬‫ﻟ‬
‫ﺍ‬

‫ﺔﻓﻲ‬
‫ﻓﺴ‬‫ﺎ‬
‫ﻨ‬‫ﻤ‬
‫ﻟ‬‫ﻠﻰﺍ‬
‫ﻳﻦﻋ‬
‫ﺭ‬‫ﺩ‬‫ﺎ‬
‫ﺍﻗ‬‫ﻮ‬
‫ﻧ‬‫ﻮ‬‫ﻜ‬
‫ﻴ‬‫ﻪﻟ‬
‫ﻴ‬‫ﻟ‬‫ﺎ‬
‫ﻩﻋ‬‫ﺀ‬
‫ﺎ‬‫ﻔ‬‫ﻛ‬
‫ﻩﻭ‬‫ﺩ‬
‫ﻮ‬‫ﻭﺟ‬
‫ﻴﻦﺫ‬
‫ﻴ‬‫ﻨ‬‫ﻬ‬
‫ﻣ‬‫‪،‬ﻭ‬
‫ﻴﻦ‬‫ﻳﺠ‬
‫ﺮ‬‫ﺩﺧ‬
‫ﺍ‬‫ﺪ‬‫ﺇﻋ‬
‫ﺩﻫﻢﺑ‬
‫ﺍ‬‫ﺪ‬‫ﻣ‬
‫ﺎ‬‫ﻟﻚﺑ‬
‫ﺫ‬‫‪،‬ﻭ‬
‫ﻤﻰ‬‫ﻟ‬
‫ﺎ‬
‫ﻭﻌ‬
‫ﻟ‬‫‪،‬ﺍ‬
‫ﻠﻰ‬‫ﻤﺤ‬
‫ﻟ‬‫ﺪﺍ‬
‫ﻴ‬‫ﻌ‬‫ﻟﺼ‬
‫ﻠﻰﺍ‬
‫ﺪﻋ‬‫ﻴ‬
‫ﻟ‬‫ﻮ‬‫ﺘ‬
‫ﻟ‬‫ﺍ‬
‫ﺀﻭ‬‫ﺎ‬
‫ﻨﺴ‬‫ﻟ‬
‫ﺍ ﺽﺍ‬
‫ﺮ‬‫ﻣ‬‫ﻳ ﺾﺍ‬
‫ﺮ‬‫ﻤ‬‫ﺎﻝﺗ‬
‫ﻣﺠ‬
‫ﺎﻝ‬
‫ﺔﻓﻲﻣﺠ‬
‫ﺜ‬‫ﻳ‬‫ﺪ‬
‫ﻟﺤ‬‫ﺎﺕﺍ‬
‫ﻴ‬‫ﻨ‬
‫ﻘ‬‫ﺘ‬‫ﻟ‬
‫ﺎ‬
‫ﻣﻞﺑ‬
‫ﺎ‬‫ﻌ‬‫ﺘ‬
‫ﻟ‬‫ﻪﻓﻲﺍ‬
‫ﻴ‬‫ﺎﺳ‬
‫ﺩﺉﺍﻻﺳ‬
‫ﺎ‬‫ﺒ‬
‫ﻤ‬‫ﻟ‬
‫ﺍ‬‫ﺍﺕﻭ‬
‫ﺭ‬‫ﺎ‬
‫ﻬ‬‫ﻤ‬‫ﻟ‬
‫ﺍ‬
‫‪،‬ﻭ‬‫ﺎﺕ‬
‫ﻣ‬‫ﻮ‬‫ﻠ‬
‫ﻌ‬‫ﻤ‬‫ﻟ‬
‫ﺎ‬
‫ﺎﻝ‬
‫ﻤﻲ ﻓﻲ ﻣﺠ‬
‫ﻠ‬‫ﻌ‬‫ﻟ‬
‫ﺒﺤﺚﺍ‬
‫ﻟ‬‫ﻴﺐﺍ‬
‫ﻟ‬‫ﺎ‬
‫ﻴﻖﺍﺳ‬
‫ﺒ‬‫ﻠﻲﺗﻄ‬
‫ﺓﻋ‬‫ﺭ‬
‫ﺪ‬‫ﻘ‬‫ﻟ‬
‫ﻬﻢﺍ‬
‫ﺑ‬‫ﺎ‬
‫ﻛﺴ‬‫ﺎﺇ‬
‫ﻳﻀ‬‫ﺍ‬
‫‪،‬‬
‫ﺘﺨﺼ ﺺ‬
‫ﻟ‬‫ﺍ‬
‫ﺔ‬
‫ﻳ‬‫ﺎ‬‫ﺮﻋ‬
‫ﻟ‬‫ﻳﻢﺍ‬
‫ﺪ‬‫ﻘ‬‫ﺪﻫﻢﻓﻲﺗ‬
‫ﺎﻋ‬‫ﺘﻲﺗﺴ‬
‫ﻟ‬‫ﺍ‬
‫ﺪﻱﻭ‬
‫ﻘ‬‫ﻨ‬‫ﻟ‬
‫ﺮﺍ‬‫ﻴ‬
‫ﻜ‬‫ﻔ‬‫ﺘ‬
‫ﻟ‬‫ﺍﺕﺍ‬
‫ﺭ‬‫ﺎ‬
‫ﻬ‬‫ﻬﻢﻣ‬
‫ﺑ‬‫ﺎ‬
‫ﻛﺴ‬‫ﺇ‬
‫ﺘﺨﺼ ﺺ‪.‬ﻭ‬
‫ﻟ‬‫ﺍ‬
‫‪.‬‬
‫ﺎ‬‫ﻬ‬
‫ﺗ‬‫ﺎ‬
‫ﻴ‬‫ﺔﻣﻦﺣ‬
‫ﻔ‬‫ﻠ‬‫ﺘ‬
‫ﻤﺨ‬‫ﻟ‬
‫ﺍ‬‫ﺍﺣﻞ‬
‫ﺮ‬‫ﻤ‬‫ﻟ‬
‫ﺍ‬‫ﻩﻓﻲ‬
‫ﺃ‬‫ﺮ‬‫ﻤ‬
‫ﻠ‬‫ﺔﻟ‬
‫ﻴ‬‫ﻟﺼﺤ‬
‫ﺍ‬

‫‪VI‬‬
 Visi
onoftheDepart
mentof
Obstetr
icsandGynecol
ogyNur
sing

TheDepar
tmentofObst
etr
icsandGy
necol
ogyNur
singseekst
obe
oneoft
hedi
sti
ngui
shedsci
ent
if
icdepar
tment
ssci
ent
if
ical
lyand
ski
ll
ful
ly at t
he l
evelof al
ldepar
tment
s of obst
etr
ics and
gy
necol
ogy i
nthe cor
respondi
ng nur
sing f
acul
ti
es i
nthe Ar
ab
Republ
icofEgy
pti
npr
ovi
dingnur
singcar
eforwomen’
sheal
thwi
th
ef
fi
ciencyandhi
ghqual
it
y.

Missi
onoftheDepar
tmentof
Obst
etri
csandGynecol
ogyNursi
ng

Mi
ssi
onoft
heDepar
tmentofObst
etr
icsandGy
necol
ogyNur
singi
s
t
oPr
epar
ing gr
aduat
es,and pr
ofessi
onal
s ofhi
gh qual
it
y and
ef
fi
ciencyt
o beabl
eto compet
eint
hef
iel
d ofobst
etr
icsand
gy
necol
ogy nur
sing at t
he l
ocaland i
nter
nat
ionall
evel
s,by
pr
ovi
ding t
hem wi
thi
nfor
mat
ion,ski
ll
s and basi
c pr
inci
ples i
n
deal
ingwi
thmoder
ntechnol
ogi
esi
nthef
iel
dofspeci
ali
zat
ion,as
wel
lasgi
vi
ngt
hem t
heabi
li
tyt
oappl
ysci
ent
if
icr
esear
chmet
hods
i
nthe f
iel
d ofspeci
ali
zat
ion And equi
ppi
ng t
hem wi
th cr
it
ical
t
hinki
ngski
ll
sthathel
pthem i
npr
ovi
dingheal
thcar
etowomeni
n
VI
I
t
hedi
ff
erentst
agesoft
hei
rli
ves.

Pr
act
icalt
rai
ningf
orObstetr
icsandGy
necol
ogi
cal
Nursing
Team member
s:Al
lst
affofobst
etr
icsandgy
necol
ogi
cal
nur
singdepar
tment
Subj
ectt
eacher
:Sami
aAbdel
-Hakeem Hassanen.
Cour
seobj
ect
ive:
Themai
nobj
ect
iveoft
hiscour
sei
stopr
ovi
det
hest
udentwi
tht
heknowl
edge
andpr
act
icest
hatenabl
ethem t
opl
anandappl
ycompet
entnur
singcar
eto
mot
her
sdur
ingl
i
fespan&hernewbor
n.
Cour
sedescr
ipt
ion:
Cour
sedescr
ipt
ionasf
oundi
ntheFacul
ty ofNur
sing atBenhaUni
ver
sit
y
Cat
aloguewi
thEngl
i
shl
anguage.
Thi
scour
sei
sdesi
gnedt
oassi
stt
hest
udent
sinunder
standi
ngt
hepr
inci
ples,
concept
sandt
echni
quesofcar
ingf
orpr
egnantwomen,mot
herandnewbor
n
babywi
thoutheal
thpr
obl
emsandpr
egnantwomenwi
thpr
e-exi
sti
ngheal
th
pr
obl
em/andwi
thpat
hol
ogi
cchangesdur
ingt
heAnt
epar
tum,
Int
rapar
tum and
Post
par
tum per
iods.Thi
scour
sef
urt
herdeal
swi
thconcept
sincar
ingf
or
nor
mal
andabnor
malhi
gh-
ri
skf
ormat
ernal
andnewbor
n.
St
udentAssessment(
Pract
ical
):
60Mar
ks
Det
ail
sasf
oll
ows:

1.Mi
d-Ter
m Exam equal
s 10Mar
ks

2.Ant
e-nat
alar
eaequal
s 15Mar
ks

3.Labourar
eaequal
s 15Mar
ks

4.Postnat
alar
eaequal
s 15Mar
ks

VI
II
5.St
udentel
ect
roni
cact
ivi
tyequal
s 5Mar
ks

Tot
alMar
ks:
60Mar
ks

LabPol
icy
1.Al
llabempl
oyees,l
abspeci
ali
sts,pr
act
icalt
rai
ner
s,andst
udent
smust
wearabadgewi
tht
hei
rnameorshow t
hei
rident
if
icat
ioncar
dbef
ore
ent
eri
ngt
hel
ab.

2.Ev
eryst
udentmustwearamaskbef
oreent
eri
ngt
hel
ab

3.Nosmoki
ngi
nsi
det
hel
ab

4.Tur
nof
fyourmobi
l
ephonewhi
l
eint
hel
ab

5.Tool
sandequi
pmentmustbeusedwi
thcar
eandcaut
ion

6.I
tisf
orbi
ddent
opr
act
iceanyact
ivi
tyi
nsi
det
hel
abot
hert
hant
rai
ning
andnur
singact
ivi
ti
es,
orwi
thoutt
hesuper
visi
onoft
hel
abt
rai
ner
sort
he
l
abspeci
ali
st.

7.Al
ltool
sandmodel
smustber
etur
nedt
othei
rpl
acesandbenchesi
n
t
hei
rpl
acesbef
orel
eav
ingt
hel
abor
ator
y

8.Al
lwast
eshoul
dber
emov
edf
rom t
hegr
oundandpl
acedi
nthet
rash

9.I
tisf
orbi
ddent
otaket
ool
sordev
iceswi
thoutper
missi
on

10. The medi

a, i
ncl
udi
ng
CDsorv
ideot
apes,mustber
etur
nedt
oit
spr
operpl
acesort
othe
r
esponsi
bleper
sons

11. Theneedl
esorsy
ringes
ar
edi
sposedofi
ntheshar
pwast
edi
sposal
bin
I
X
 Cl
assPol
icy
1.St
udent
sshoul
d bepunct
ualf
ort
hel
ab act
ivi
ti
esand ot
herr
elat
ive
meet
ings.
2.Al
lst
udent
sar
eexpect
edt
obehav
einacour
teousandr
espect
ful
manner
t
oacademi
cst
aff
,fel
l
owst
udent
sandadmi
nist
rat
ivest
aff
.
3.Dur
ingski
l
lsl
abact
ivi
ti
es,
mobi
l
ephonesshoul
dbeswi
tchedof
f.
4.Mobi
l
ephoneswi
thcamer
asar
enotal
l
owedi
nsi
det
hel
ab
5.St
udent
swhosebehav
iori
sconsi
der
edi
nappr
opr
iat
emaybeaskedt
o
l
eav
ethecl
ass.
6.St
udent
sar
eal
l
owed t
o askquest
ionsdur
ingski
l
lsl
ab act
ivi
ti
esf
or
seeki
ngcl
ari
fi
cat
ions.
7.St
udent
sshoul
drespectt
he cul
tur
e oft
he communi
ty(
clot
hing,l
ab
uni
for
msusedi
nthel
abandcommuni
cat
ion)
.
8.Smoki
ngi
snotper
mit
tedi
nthecl
assr
oom andl
abor
ator
y,exami
nat
ion
r
oom i
nsi
det
hef
acul
tyenv
ironment.
9.Thest
udent
sar
eexpect
edt
obehonestatal
lti
mes.
10.
Student
s shoul
drespect t
he cul
tur
e of communi
tyt
rough good
communi
cat
ion.
X
11.
The st
udent
s ar
e notal
l
owed t
o ent
ert
he l
abor
ator
y unl
ess wi
th
l
abor
ator
yuni
for
m.

12.
Studentshoul
dtr
eati
nfor
mat
ionr
ecei
vedf
rom pat
ientorobt
ainedf
rom
pat
ientr
ecor
dasconf
ident
ial
.

13.
Student
sshoul
dueshospi
talsuppl
i
espr
oper
lyanduest
hem f
ort
hei
r
i
ntendedpur
pose.
14.
Student
s ar
e notal
l
owed t
otaki
ng pi
ctur
s ofpat
ienti
nsi
de t
he
i
npat
ient
room .

War
ningl
ett
ers
st
 1 war
ningl
ett
er=10%f
rom t
otal
hour
s.=12-15hour(
2day
s)
appr
oxi
mat
ely

 2ndwar
ningl
ett
er=15%=18hour f
rom t
otal
hour
s.(
4-5day
s)

 3rdwar
ningl
ett
er=25% =24hourf
rom t
otal
hour
s.(
6day
s)

 Forex
ampl
epr
act
ical
cour
sear
e12hour
s/weekf
or13weeks.

 12x13=156hour
s.

XI
  Thestudentsshoul
dbeat
tendal
lcl
i
nical
area75%atacademi
c
semester.

Cl
ini
calRot
ati
onsatBenhaUnver
sit
yHospi
tal&Lab
Skil
ls

4thweeks
Labski
l
l 1stweek 2nd week 3rd week 4th week
Ori
antaion antenatal l
abourcar
e Postnatal
care care
Antenal
Unit Thr
eeweeks
Labour
Unit Thr
eeweeks
XI
I
Post
natal
Uni
t Thr
eeweeks
Week14
Rev
isi
on
Week15
Fi
nal
Exam

Dai
lySt
udent
sAct
ivi
ty

Dat
e Act
ualAct
ivi
ty Comment
s

XI
II
 St
udentSi
gnat
ure:
……………………………
I
nst
ruct
orsi
gn.
:
……………………………

Ant
enat
alar
ea

Cl
i
nicalobj
ect
ives:
1.Ut
il
izesnur
singpr
ocesst
opr
ovi
decar
eforapr
enat
alcl
i
ent
s.

2.Rel
atesnut
ri
ti
onal
requi
rement
sfort
hepr
egnantcl
i
ent
.

3.Di
scusses t
he common di
scomf
ort
s ofpr
egnancy and suggest
ed
comf
ortmeasur
es.

Thr
oughcl
ini
calt
rai
ningt
hest
udentnur
sewi
llbeabl
eto:
XI
V
1.Demonst
rat
eabi
l
ity&ski
l
lsi
nhi
stor
ytaki
ngofant
enat
alMot
her
s.

2.Demonst
rat
eski
l
lsi
nant
enat
alassessment
.

3.Makes r
elev
antobser
vat
ions & r
ecor
d&r
epor
tst
hempr
ompt
ly&
ef
fect
ivel
y.

4.I
dent
if
ies r
isk f
act
ors & manages emer
gencysi
tuat
ionsef
fect
ivel
y&
pr
ompt
ly.

5.Per
for
m abdomi
nalpal
pat
iont
oident
if
yfet
alposi
ti
on&l
ocat
efet
alhear
t
r
ate.

6.Cal
cul
ate ex
pect
ed dat
e ofdel
i
ver
yaccor
ding t
ofi
rstdat
e ofl
ast
menst
rual
per
iodandcal
cul
ategest
ati
onal
age.

7.Demonst
rat
e ski
l
lsi
nident
if
ying t
he needs & pr
obl
ems of
ant
enat
al
mot
her
s.

8.Demonst
rat
e ski
l
lsi
nint
raut
eri
ne f
etalmoni
tor
ing t
o assess f
oet
al
gr
owt
handwel
lbei
ng.

9.Demonst
rat
eabi
l
ityt
oimpl
ementt
hepl
annedcar
etoant
enat
almot
her
s.

10. I
nst
ructpr
egnantmot
herabout/
Schedul
eofr
out
ineant
enat
al
v
isi
t,i
mpor
tance ofant
e nat
alf
oll
ow up,br
eastf
eedi
ng .
nut
ri
ti
on
.
i
mmuni
zat
ion.
hygi
eni
ccar
e,r
est&sl
eep,chi
l
dbi
rt
hpr
epar
ati
on,f
ami
l
y
pl
anni
ng&i
dent
if
icat
ionofdangersi
gnsofpr
egnancyandsi
ngsoft
he
onsetofl
abour
.

Ant
enat
alEv
aluat
ionsheet
XV
 I
temsofev
aluat
ion Tot
al St
udent Comment
mark mar k
Per
sonaldi
gni
ty:
- Absent
eeism 9
- Organi
zat
ion 1
- Grooming 1

Af
fect
iveDomai
n:-
- Relationshi
pwi
thpat
ient 1
- Staff. 1
- Colleagues. 1
- Behav ior 1

Appl
i
cat
ionofnur
singpr
ocess 5

Assessmentsheet 5

Mot
hercl
ass 3

I
ntel
lect
ualDomai
n:

- Oralexam. 10
- Quiz. 10

Psy
chomot
orDomai
n:-

- Pit
tingedemaassessment 2
- Admi nistrat
ionofmagnesium 2
shlphate
- Auscul t
ationofF.H.R. 2
- Deept endonr efl
ex 2
assessment 2
- Abdomi nalexaminati
on. 2
- Assessmentoff i
rstphysi
cal
exami nation

Tot
al 60

St
udent
'ssi
gnat
ure:
- I
nst
ruct
or'
ssi
gnat
ure:
-

XVI
 Ant
e-nat
alassessment
:
Obt
ainingahealt
hhi
stor
yfr
om t
hepr he1ST ant
egnantwomanatt e-nat
alv
isi
t:
(
Bookingcli
nic)

Dat
eofassessment
:

Name: Age:

Gr
avi
da: Par
a: LMP: EDD:

Demogr
aphi
cdat
a/f
ami
lypr
ofi
le:

*Lev
elofeducat
ion: *Occupat
ion:

*
HusbandsOccupat
ion:

*
Housi
ng: (
Wit
hwhom doy
oul
i
ve) Nucl
ear
/Ext
endedf
ami
l
y

Gener
alheal
thhi
stor
y:

*
All
ergi
es (
Checkspecif
ical
l
ywhet
heral
l
ergi
ctoanyf
oodor
Medicati
on.
*
Hist
oryof
:
 Heartdi
sease,
rheomat
icf
ever
,hy
per
tensi
on.

 Di
abet
esmel
l
itusorgest
ati
onal
diabet
es.

 Br
onchi
alast
hma,
tuber
cul
osi
s(TB)
,orchr
oni
cbr
eat
hingpr
obl
em

 Thy
roi
ddi
sease.

 Recur
rentconv
ulsi
on.

 Ur
inar
ytr
acti
nfect
ion.

 Sex
ual
l
ytr
ansmi
tt
eddi
sease.

 Hospi
tal
admi
ssi
on.(
Det
ail
s).

 Oper
ati
on(
det
ail
s).

Fami
lyhi
stor
y:

Hi
stor
yof
:
 Cardi
ovascul
ardi
sease

XVI
I
  Renal
disease

 Di
abet
esmel
l
itus.

 Bl
ooddi
sor
der
s

 Congeni
tal
abnor
mal
i
ties

 Ment
alr
etar
dat
ion.

Soci
alHi
stor
y:
 Smoki
ng det
ail
s:-

 Al
cohol
int
akeordr
ugabuse. Det
ail
s:-

 Ex
erci
se.

Gy
necol
ogi
calhi
stor
y:
 Ageofmenarche

 Menst
rual
cycl
e (
int
erv
al,
dur
ati
onandamountofmenst
rual
flow)

 Dy
smenor
rea

 Gy
necol
ogi
cal
sur
ger
y

 Hi
stor
yofst
ressi
ncont
inence

 Met
hodofcont
racept
ion.

Obstet
ri
chistory:
Hist
oryofpreviouspr
egnanci
es
(Completebeloweachbirt
hfrom el
destchi
l
dtoy
oungest
)

*
Chi
l
d *
Sex *
Gest
ati
ons *Bi
rt
hWi
ght

*
Compl
i
cat
ions(
Dur
ingl
astpr
egnancy
,Labororpuer
per
ium orBr
eastf
eedi
ng,
)

XVI
II
-
Cur
rentpr
egnancy
:-Gest
ati
onbydat
e’s(
weeks)

*
Signsofear
lypr
egnancy
:

*
Dat
eofposi
ti
vepr
egnancyt
est
:

*
Medi
cat
iont
akendur
ingt
hispr
egnancy
:

*
X-r
ayt
akendur
ingt
hispr
egnancy
? (
Det
ail
sofX-
ray
sanddat
e)

Basel
inedat
afor
:

*
Wei
ght(
KG) *Hei
ght(
cm)

*
Temper
atur
e: *Pul
se *
Respi
rat
ion: *Basel
i
neBp

*Uri
neanalysis *oedema(pre-t
ibi
al,
finger
,face)
*Glucose
*Pr
otein
*Ketones
Physi
calexaminat
ion: ( Thoroughl
ycheckfr
om headtotoeandnot eanypr
obl
ems.
seephysi
calexaminati
onformat)

Abdomi
nalPal
pat
ion:
-(
asappl
icabl
e)

*
Appear
ance:

*
Hei
ghtoff
undus(
gest
ati
on)

*
Lie

*
Present
ati
on:

*
Posi
ti
on:

XI
X
*
Fet
alheadengagedornotengaged

*
Fet
almov
ementf
elt

*
Fet
alhear
tbeathear
d:

-
Labor
ator
yanal
ysi
s

*
Bloodgr
oup/
Rhesusf
act
or: *
Hemogl
obi
n(HB)
:

*
Ser
ologi
cal
testf
orsexual
transmi
tt
eddi
sease(
STDS)

*
Ant
ibodyt
it
erf
or:-Hepati
ti
sB:
-Rubell
a
-HumanI mmunodi
ff
encyv
irus(
HIV)

*
Mid-
str
eam uri
nesample(
MSU)toexcludeur
inar
ytr
acti
nfect
ion:
(
Micr
o-organi
sm,cul
tur
eandsensi
ti
vi
ty)

Li
stbel
owanycur
rentheal
thpr
obl
emswi
thpl
anofcar
e:-
Exampl
e(anemi
a,nausea,
hur
tbur
nur
inar
ypr
obl
em v
agi
nal
dischar
gev
ari
cosev
ain,
hemorr
hoi
d.)
Pr
obl
ems Obj
ect
ives Heal
theducat
ion

XX
Gl
ossar
yofAnt
enat
alper
iod:
 Gest
ati
on:

 Gest
ati
onalage:

XXI
 Gr
avi
dit
y:

 Mul
ti
grav
ida:

 Pr
imi
grav
ida:

 Nul
li
grav
ida:

 Par
it
y:

 Pr
imi
par
a:

 Nul
li
par
a:

 Mul
ti
par
a:

 St
il
lbi
rt
h:

 Concept
ion:

 Ant
enat
alper
iod:

 Amenor
rhea:

 Chl
oasma:

 Posi
ti
vesi
gnsofpr
egnancy
:

XXI
I
  Pr
obabl
esi
gnsofpr
egnancy
:

 Nagel
e'
srul
e:

Exampl
e:
LMP:1 4 2021

-
..
..
..
..
..
.-
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
--
-
..
..
..
.. ...
..
. . .…
 Abor
ti
on:

 Fet
alat
ti
tude:

 Li
e:

 Posi
ti
on:

 Pr
esent
ati
on:

 Pr
eter
mlabor
:

Thef i
rstphy
sicalexami
nat
iondur
ing
pregnancy

St
udent: Gr
oup:
Date:
Cl
ini
calar
eaoft
rai
ning
Pr
ocedur
es Done Notdone
1-
Prepar
eequi
pment
.

XXI
II
Pr
ocedur
es Done Notdone
2-
Welcomethewoman,andcal
lherbypr
efer
red
nametheni
ntr
oducey
our
sel
fbynameandj
obti
tle.
Takecompl
etehi
stor
yfr
om t
hewoman.
-3
4-
Uri
net
est
:
Inst
ructthemothertoev acuat
ethebladder
andcollectmi
dst
ream specimenofur
ine.
 Testur
inef
orpr
otei
n,sugarandket
one.
5-Bloodtest:
 Hbtestingonever
yvi
sit
,onceamont
hto
excl
udeanemi a
 Bl
oodgr oupandRH
 TORCHTest
6-Generalexaminat
ions
Measure accurat
ely woman’
s weightwi thout
shoes( Tot
alweightgainduri
ng pregnancyi s
approx
imately11kg).
 Measur
eaccur
atel
yherhei
ghtwi
thoutshoes.
Measur
ingv
ital
signs.
 Exami
nat
ionoft
hehead:
- Checkherf
orl
i
ceandni
ts
- Checkt
hef
acef
orpal
er,edemaandf
aci
al
ex
pressi
on.

- Checkconj
unct
ivaf
ordegr
eeofr
edness.
- Not
e any pi
gment
ati
on on f
orehead and
cheeks.
- Exami
nemout
hforcondi
ti
onofgumsand
t
eet
h.
 Exami
nat
ionoft
heneck:
- Checkt
hyr
oidgl
andf
orenl
argement .

XXI
V
Pr
ocedur
es Done Notdone
- t
heneckshoul
dal
sobet
hor
oughl
yexami
ned
forenlar
gedlymphnodes.Theareasabov
e
theclavi
clesandbehi
ndt heear
smustbe
palpat
ed.

Exami
nat
ionoft
hechest
:
Assi
stwi
th exami
nat
ion ofthehear t&lungsby
prepar
ingthewoman.
Exami
nat
ionoft
hebr
east
:
Ex
- ami
neni
ppl
es&Ar
col
a.
The ax
- i
l
lae and i
ngui
nalar
eas shoul
d al
so be
exami
nedf
orenl
argedl
ymphnodes.
Exami
nat
ionoft
heext
remi
ti
es. -

-Checkt
hecol
orofpal
msandnai
l
s
-Exami
net
hel
egsankl
esandf
eetf
orshapeand
unequal
lengt
h.
-Checkedemaov
ert
het
ibi
a,ankl
eandf
eet
.
-Obser
vel
egsf
ordi
l
atedv
ein
7-Localexami
nat
ions:
 Exami
nat
ionoft
heabdomen.
 Assi
stwi
thpel
vi
cexami
nat
ions.
8- check t
he woman f
or danger signs of
pregnancy
.
9-Postexami
nat
ionsst
eps:
- Assi
st t
he woman t
o get down f
rom
ex
ami
nat
iont
abl
eandwearhercl
othes.
- Recor
dfi
ndi
ngandwomanr
eact
ion.
- Repl
aceequi
pment
.
- Washhands.
- Gi
vet
he woman t
he necessar
yinst
ruct
ions
XXV
Pr
ocedur
es Done Notdone
andt
hedat
eofnex
tvi
sit
.
- Ref
erabnor
mal
case.

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

Fundalhei
ghtduri
ngpregnancy
checkl
ist

St
udentname: Group:
Dat
e: Cl
ini
calareaoft
rai
ning:
-

XXVI
 Procedur
es Done Notdone
1-
Washhands.

2-
Expl
aini
ng pr
ocedur
e and pur
pose of i
tto
mot
her
.

3-Aski
ngmot
hert
oempt
yherbl
adderbef
oret
he
Pr
ocedur
e.

4-
Posi
ti
oni
ngmot
heronherbackonexami
nat
ion
t
abl
e.

5-Thest
udentst
andson t
her
ightsi
deoft
he
mot
herandt
heul
narbor
deroft
hel
efthandi
s
mov
edf
rom t
hexi
phoi
dcar
ti
lagedownwar
d
unt
ilt
her
esi
stanceoft
hef
undusi
sfel
t.

6-Thest
udenti
dent
if
iesgest
ati
onal
age

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

Abdomi
nalexaminat
ion
checkl
ist

St
udentname: Gr
oup:

XXVI
I
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
es Done Notdone
Bef
oreprocedur
e:
1.Washhands and 
doPPE 
i
f
appropr
iat
e.

2.I
ntr
oducehim\hersel
ftothepat
ient
i
ncl
udingname and r
ole.

3.Conf
ir
mthepat
ient
’s 
name 
and 
dat
e
ofbi
rt
h.

4.Explai
n procedur
eto 
pat
ientwi
th
fr
iendl
y language

5.Obtai
nconsent
 t
opr
oceedwi
tht
he
examinat
ion

6.Provi
dethewomanwi t
hthe
opport
unit
yto pass 
uri
ne 
bef
oret
he
examinat
ion.

7.Posi
ti
onherondor
salr
ecumbent
posi
ti
onwit
hkneessl
i
ghtl
yfl
exed

8.Adequately
 expose 
the 
pat
ient
’s
abdomen fortheexaminat
ionfr
om
thepubicsymphy si
stothe
xiphi
ster
num

:
Inspect i
on
-Standonr i
ghtsi
deoft hewoman
Obser vetheabdomenf orSi
zeinrelat
ionto
periodofamenor r
hea.
Not etheshapeandcont ourofthe
abdomen.
Sur gi
calScars
Pigment ati
ons:(Str
iae gravi
darum-Li nea
ni
gra)
Palpation:
XXVI
II
Fundall
evel
:St
udentcanlocat
ef undall
evel
andi
denti
fygestati
onalage.

Fi
rstmaneuver(
:f
undalpal
pat
ion)
1-Studentf
acethewoman’shead.

2-Placehandspalm downwar dswi t

h
fi
ngerclosetoget
heronthef undus,
gentl
yfeelwi
ththefi
ngert
ips.

Thesecondmaneuver :
(Lat
eralpalpati
on)
1.StudentPlacehandsonei t
hersideofthe
pati
ent’
suterus(ensur
ingyouar efaci
ng
t
hepat i
ent)
.

2.
 Gent
lypal
pat
eeachsi
deoft
heut
erus.

Thi
rdmaneuv er :
(pel
vi
cgr i
bs).
*Fi
rstpelvi
cgrib:(
Pawli
k’sgri
bs)
Thest udentgraspsthelowerpartofthe-
uterusbetweenindex&thumb.
-Spr
eadwi
deenought
of i
tthehead,don'
t
putmuchpressur
e.
*Secondpelvi
cgrip:
1-Thestudentt
urnstof
acet
hewomenf
eet
2-
Askthewomentobendherkneessl
i
ghtl
y
andbr
eat
hsteadywi
thhermouthopen
3-
Holdthesidesofthelowerabdomenunti
l
fi
nger
sclosetoget
her,poi
nti
ngdownwar ds
andi
nwar d

Auscul
tat
ion:
1.
 Thestudentpl
acet
hePi nar
d
st
ethoscopeonanter
iorshoul
der(about5
cm abovetheheadonthesideofabdomen
wherethebackwasfelt
).

2. 
Thestudentpl
aceeartothePinardand
takehandaway(sothePinardisheld
againstt
heabdomenusingy ourearonl
y).
XXI
X
3.
 Pal
pat
emat
ernal
pul
se.

4.
 Li
stenf
ort
hef
etal
hear
tbeat
:

Postpr
ocedur
etask:
Expl
ain 
to the pat ient that t
he
examinat
ioni
snow 
fi
nished.

Re-covert
hepatient– al
low t
hepat
ient
ti
met ore-
dressi
nprivacy
DisposeofPPE appropri
atel
yand 
wash
yourhands.

Summar
izef
indi
ngs.

St
udentsi
gnat
ure:
- Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

XXX
 Nur
singcar
eofhi
gh-
ri
skpr
egnancy
Car
ingf
orEcl
ampt
icPat
ientcheckl
ist
St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
es Done Notdone
Dur
ingConv
ulsi
ons

 Keepai
rwaypat
ent
;tur
nheadt
o one
si
deandpl
acepi
l
lowunderoneshoul
der
orback

 Womanmayneedr
est
rai
ntt
opr
eventher
f
rom i
njur
ingher
sel
f.

 Mout
hgagi
spl
acedbet
weent
hej
awst
o
pr
eventherbi
ti
nghert
ongue.

 Thet
onguei
shol
dbyt
onguef
orcepst
o
pr
eventi
tfr
om f
all
i
ngbacki
nthemout
h
andbl
ocki
ngai
rway

 Oxy
genmask.
 Pr
otectwi
thsi
der
ail
supandpadded.
 Cal
lforassi
stance.
 Obser
veandr
ecor
dconv
ulsi
onact
ivi
ty

PostConv
ulsi
onsCar
e
 Obser
ve f
or post conv
ulsi
on coma,
XXXI
 i
ncont
inence.
 Woman i
str
ansf
err
ed i
mmedi
atel
yto
r
oom ofecl
amsi
awhi
chi
sisol
ated,
semi
-
dar
k,cal
m wi
thr
ubberf
loor
.

 Womani
sputonl
eftl
ater
alposi
ti
on

 Footoft
he bed can be el
evat
ed t
o
enhancebr
onchi
aldr
ainage

 Besi
de bed:
oxy
gen cy
li
nder
, suct
ion
appar
atus,t
raycont
aini
ng (
mout
h gag,
ai
rway
,fol
y’
scat
het
er,canul
a,hammer
,
dr
ugs as MGSO4, CA gl
uconat
e,
ant
ibi
oti
cs,
oxy
toci
n)

 Food&f
lui
dar
esuct
ionedf
rom t
rachea
 Admi
nist
erox
ygenv
iaf
acemaskat10L/
mi
n.
 St
artI
Vfl
uidsandmoni
torf
orpot
ent
ial
f
lui
dov
erl
oad.
 Gi
veMgSo4 orant
iconv
ulsantdr
ug as
or
der
.
 Fol
l
owt
hepr
ecaut
ionsofgi
vi
ngMgSo4
I
nser
tindwel
l
ingcat
het
eri
srequi
red
 Thef
etusi
smoni
tor
ed.
 Assessment of ut
eri
ne act
ivi
ty and
cer
vical
stat
us.

XXXI
I
 Moni
torbl
oodpr
essur
e.
 Medi
cat
ionsar
egi
venasor
der
ed.
 Lab. Assessment i
ncl
ude met
abol
i
c
package f
or l
i
ver enzy
me,CBC wi
th
pl
atel
ets,
coagul
ati
onpr
ofi
l
e
 Pr
ovi
dehy
gieni
ccar
e.
 Pr
ovi
dequi
etenv
ironment
 Bepr
epar
edf
orbi
rt
hwhent
hewomani
s
st
abl
e.

St
udentsi
gnat
ure:
- Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

XXXI
II
 Pi
tt
ingEdemaAssessment
checkl
i
st
St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-
Pr
ocedur
es Done Notdone
1-
Greett
hemot
her
.
2-
Expl
aint
hepr
ocedur
e.
3-
Posi
ti
ont
hemot
herf
lati
nthebed.
4-
Washhands.
5-
Obser
vef
orgener
alappear
ance(
ski
ntext
ure,
swel
l
ing)
.
6-
Inspectt
hewomanf
ace,
ext
remi
ti
es,
andsacr
al
ar
ea
7-
Presseachar
eaf
ir
mlywi
tht
het
humbori
ndex
f
ingerf
orsev
eral
secondsandr
elease.
8-
Eval
uat
etheext
ensi
venessoft
heedema,
the
dept
hoft
hedepr
essi
on,
andt
hel
engt
hoft
imei
t
t
akes

XXXI
V
 9-
Gradet
hepi
tt
ingedemaaccor
dingt
othe
f
oll
owi
ngscal
e:
1+=Mi
nimal
edemaoft
hel
ower
ex
tremi
ti
es.
2+=Mar
kededemaoft
hel
ower
ex
tremi
ti
es.
3+=edemaoft
hel
owerext
remi
ti
es,
face,
andhands.
4+=Gener
ali
zed,
massi
veedema.

Post
-pr
ocedur
e:
10-
Recor
dand.Compar
ethef
indi
ngwi
tht
hose
pr
evi
ousl
yrecor
ded.
11-
Cov
ert
hewomanandkeepheri
ncomf
ort
abl
e
posi
ti
on

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

XXXV
 Labourar
ea
Cl
ini
cal
obj
ect
ives:

Tomai
ntai
ntheheal
thandwel
l
-bei
ngofpr
egnantwomenandt
hei
rof
f-
spr
ings
dur
ingt
hei
ntr
anat
alper
iod,keept
hewomeni
nlaborundercl
oseobser
vat
ion
andav
oidi
nter
fer
encewi
tht
henat
uralpr
ocessofdel
i
ver
yunl
esst
her
eisa
v
ali
dreason t
o do so,
encour
age and suppor
twomen i
n l
abor
 and ext
end
per
sonal
att
ent
ion.
Thr
oughcl
ini
calt
rai
ningt
hest
udentwi
llbeabl
eto:

1.Appl
ypar
togr
am t
ofol
l
ow upl
aborpr
ogr
ess&i
dent
if
ythecondi
ti
ons
t
hatcanbecompl
i
cat
ed.

2.Pr
ovi
denur
singi
nter
vent
ionf
orf
etal
andmat
ernal
dist
ressdur
ingl
abor

3.Assessut
eri
necont
ract
ion& demonst
rat
eabi
l
ityt
oper
for
m gener
al,
abdomi
nal
&perv
agi
nal
exami
nat
ion.
XXXVI
4.Appl
ysuppor
ti
vemeasur
esf
ormot
herdur
ingl
abor
.

5.Pr
ovi
decar
eformot
her
sundert
akenoxy
toci
nei
nfusi
ondur
ingl
abour.

6.Di
spl
ayski
l
lsi
ntr
oll
eyset
ti
ng & assi
sti
ng i
ninst
rument
aldel
i
ver
ies&
ot
herpr
ocedur
es.

7.Conf
ident&ski
l
lfulhandl
i
ngi
nnor
maldel
i
ver
ieswi
thepi
siot
omy&appl
y
i
mmedi
atebabycar
e.
nd r
d
8.Abl
etocar
ryoutheal
tht
eachi
ngdur
ing2 &3 st
ageef
fect
ivel
y.

9.Abl
etocal
cul
atet
heapgarscor
eat1&5mi
nut
eaf
terbi
rt
h.

10. Mot
ivat
emot
herf
ori
mmedi
atebabysuckl
i
ngoft
hebr
east
.

11. Per
for
m ut
eri
nemassageandr
ecor
danyabnor
mal
i
ties.

12. Maker
elev
antobser
vat
ions&r
ecor
ds&r
epor
tst
hempr
ompt
ly&
ef
fect
ivel
y.

LabourEv
aluat
ionsheet

I
temsofev
aluat
ion Tot
al St
udent Comment
mark mar k
Per
sonaldi
gni
ty:
- Absent
eeism 9
- Organi
zat
ion 1
- Grooming 1

Af
fect
iveDomai
n:-
- Relationshipwi
thpat
ient 1
- Staff 1
- Colleagues. 1
- Behav iour. 1

Appl
i
cat
ionofnur
sing 10
XXXVI
I
pr
ocess&Par
togr
am

Assessmentsheet 5

I
ntel
lect
ualDomai
n:

- Or
alexam. 10
- Wri
tt
enexam. 10

Psy
chomot
orDomai
n:-

- Managementoft
he1stst
age 2
ofl
abor
- Managementoft
he2ndstage 2
ofl
abor
- Vagi
nalexami
nat
ion. 2
- I
mmedi at
ecar
eofnewborn 2
- Managementoft
he3rdst
age 2
ofl
abor

Tot
al 60

St
udent
'ssi
gnat
ure:- I
nst
ruct
or'
ssi
gnat
ure:
-

XXXVI
II
XXXI
X
 l
abourr
ecor
d
Mother'
sname:- age:- L.M.P.
Sect
ion:- di
agnosi
s:- E.D.D.
e V.
Dat S F.H.S GRI
PS U. P.V I .
V.F Mothers Ng. ev
aluat
- C need car
e e
t
ime

Nur
singcar
epl
an(
Recov
ery)
XL
 Mot
her
'sname: par
it
y: gest
ati
onalage:
Age:- posi
ti
on:- l
ie:
-
Date Assessment Nur
singcar
e Ev
aluat
ion
-
ti
me

I
mmedi
atebabycar
erecor
d
XLI
 Mot
her
'sname: L.
M.P.
: E.
D.D.
:
Babysex:
- Ty
peofdel
iv
ery
:-

Date Assessment Nur

singcar
e Ev
aluat
ion
-
ti
me

XLI
I
 Apgarscor
echar
t
Mothername:
Ti
meofdel i
ver
y:- dat
eofadmi
ssi
on:
-

Procedure Zer
o 1 2 1mi
n 5mi
n
st
eps
Respir
atory Absent Sl
ow Goodcr
y
eff
ort i
rr
egul
ar

Absent Bel
ow Ov
er100p/
min
Hear
trat
e 100p/
min

Muscl
etone Fl
acci
d Some
fl
exi
onof Wel
lfl
exed
l
imbs

Ref
lex No Gr
imace Coughof
r
esponse sneeze

Col
our Blueor Bodypi
nk, Allpi
nk
pale l
imbsbl
ue
Total
:-

Apgarscor
eri
sk:-
1-
4H. R highr
isk
5-
7M. R moderater
isk
7-
8S.R smal
lri
sk
10normal

XLI
II
Gl
ossar
yofI
ntr
apar
tum per
iod:
 Labor
:

 Cer
vicaldi
lat
ati
on:

 Cer
vicalEf
facement
:

 Engagement
:

 Ext
ernalos:

 I
nter
nalos:

 Pl
acent
a:

 Accel
erat
ion:

 Decel
erat
ion:

XLI
V
 MANAGEMENTOFFI
RSTSTAGEOFLABOR
St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
es Done N0tDone
:
(1)Admi
ssi
on
 Washhands
 Pr
epar
eequi
pment
 Wel
comeandgr
eatt
hewomanki
ndl
y
 Ex
plai
n al
lpr
ocedur
es per
for
med t
o
par
tur
ientwomen.
 Ensur
epr
ivacyandconf
ident
ial
i
ty.
 Seeki
nfor
medconsent
.
 Hel
pwomenundr
essandgeti
ntobedi
f
t
her
ear
eanycompl
i
cat
ionsasbl
eedi
ng,
pr
emat
urer
upt
ure ofmembr
ane,wi
th
hi
gh head, hy
per
tensi
on, car
diac
di
sease,
oranyot
hermedi
cal
probl
ems.

XLV
2.
Appl
ymeasur
esofi
nfect
ioncont
rol
 Fol
l
ow t
he asept
ict
echni
ques i
n
eachpr
ocedur
etopr
eventi
nfect
ion.
 Changet
heper
ineal
padf
requent
lyi
f
t
her
eisexcessi
vev
agi
nal
dischar
ge.
 Hel
pthe woman t
o weara cl
ean
gown
 Per
for
m per
inealcar
eonadmi
ssi
on
t
hen bef
ore and af
ter v
agi
nal
ex
ami
nat
ion. Bef
ore del
i
ver
y and
cat
het
eri
zat
ion.Thencov
ert
hev
ulv
a
wi
thst
eri
l
epad.

XLVI
(
3)Takehi
stor
y
Per
sonalhi
stor
y: suchasname,addr
ess,
age,l
evelof educat
ion,occupat
ion and
dur
ati
onofmar
ri
age.

Presenthi
stor
y:gushoft
hewat
er,t
ruel
abor
pain

 Obstetr
ichi
stor
yincl
udi
ng
Par
it
y,gravi
da,
Previ
ousdel
iver
iesasmode
ofdel
i
ver
y,det
ail
sofpr
evi
ouspost
par
tum
per
iod,
cont
racept
ivehi
stor
y.
a. LMP,
EDD
b. Onsetoft
ruel
aborpai
ns
c. Mat
ernal
appr
eci
ati
onoff
etal
mov
ement
s
Medi
cal hi
stor
y: such as D.
M, car
diac
di
seases

XLVI
I
(
4)Det
ermi
net
hepr
esenceoft
hef
oll
owi
ng:
 Ut
eri
necont
ract
ions:Askt
he
womanwhent
ruecont
ract
ion
beganandassessi
tsf
requency
,
i
ntensi
ty,
anddur
ati
onwi
thi
n10
mi
nut
esev
ery30mi
nut
es.
 Show:askt
hewomani
fshehada
bl
oodst
ainedmucousdi
schar
ge.

XLVI
II
  Membr
anes:ask t
he woman i
f
shehadagushoff
lui
dornot
,if
shei
snot
,ifshei
snotsur
e,use
l
i
tmus paper and smel
litt
o
excl
udeur
ine.I
fmembr
anesar
e
r
upt
ured r
ecor
d t
he t
ime of
r
upt
ure.
 Fr
equency of mi
ctur
ati
on: i
t
occur
sasar
esul
tofengagement
.
The pr
essur
e oft
he pr
esent
ing
par
t on t
he ur
inar
y bl
adder
decr
easesi
tscapaci
ty.
 Cer
vicalchanges:shor
teni
ngand
di
l
ati
ngoft
hecer
vix.Thr
oughper
v
agi
nal
exami
nat
ion.
I
ntheLat
entphase:cer
vicaldi
l
atat
ioni
s
l
ess t
han 3 cm (
slow cer
vical
ef
facement
).
I
ntheAct
ivephase:cer
vicaldi
l
atat
ioni
s
f
rom 3-
10 cm (
progr
essi
ve cer
vical
di
l
atat
ion)
.
 Pr
imi
grav
ida:cer
vixdi
l
atesatl
esst
han
1.
2cm/
hour
.
 Mul
ti
grav
ida:cer
vixdi
l
atesatl
esst
han
1.
5-2cm/
hour
.
 For
mat
ionoft
hebagofwat
er.

XLI
X
 Act
iveManagementofFi
rstst
ageofl
abor

Pr
ocedur
e Done NotDone

1.Mat
ernalAssessment

1-TakeVi
tal
signsbet
weencont
ract
ions.
2-Gener
alexami
nat
ion:
obser
vef
orgener
alwel
l
bei
ng
3-Localexami
nat
ion

Abdomi
nal exami
nat
ion(
Leopol
d’
s-1
maneuv
er)
:i
nspect
ion,
pal
pat
ion,
auscul
tat
ion.
a.I
nspectf
orabdomi
nal
scar
,fet
almov
ement
s
andedemaofabdomi
nal
wal
l
b.Pal
pat
efundal
lev
el
c.Auscul
tat
eFet
alhear
tsounds/
beat
/tone

2-
Vagi
nalexam:
exami
negeni
tal
i
a:
4-Lookf
ort
ender
ness,
swel
l
ing,
dischar
ge,
ulcer
s;
check per
ineum f
or scar
s, l
esi
ons,
i
nfl
ammat
ion,moni
l
iamayl
ead t
orupt
ureof
membr
ane,human papi
l
loma v
irus,swol
l
en
bar
thol
i
n’sgl
and.

5-Assessdi
l
atat
ion,ef
facement
,st
ati
on,mol
ding,
engagement
.

L
3-
Rout
inei
nvest
igat
ion:
- Ur
ineanal
ysi
s :f
orpr
otei
ns,gl
ycosur
ia,pus
cel
l
s,sal
ts.

- Bl
oodexam:
forHb%,
RBCs,
ABOandRH

- Bl
oodgl
ucosel
evel

Pr
ogr
essofl
abor(
cer
vical
changesandut
eri
ne
cont
ract
ions)
.

Nut
ri
ti
onandHy
drat
ion
 Dur
ingl
abor
,ther
eisanex
cessi
vel
ossof
f
lui
dsandi
ncr
easedt
het
endencyt
o
ex
haust
ionanddehy
drat
ionduet
ost
rong
muscl
escont
ract
ion
 Women'
sneedf
orener
gyi
smett
hrough
nour
ishi
ngor
alf
lui
datf
requenti
nter
val
sto
mai
ntai
nthef
lui
dbal
ance.
I
.V.f
lui
dsar
egi
vent
opr
ovi
deener
gyand
pr
eventdehy
drat
ioni
ncaseofv
omi
ti
ng,
ket
osi
s
andpossi
bleuseofanest
hesi
a.
 Dur
ingear
lyl
abor
,thewomanshoul
drecei
ve
about75ml
off
lui
dperhouri
nthef
orm of
j
uices,
soups.
 Mai
ntai
nint
akeandout
putchar
t.
 Di
etshoul
dbenut
ri
ti
ous,
easi
l
ydi
gest
ibl
eand
smal
li
namount
.
 Sol
dfoodi
susual
l
yav
oideddur
ingt
heact
ive

LI
 l
abor

RestandSl
eep(
Pai
nrel
i
ef)
 Anxi
etyandut
eri
necont
ract
ionspr
oduce
sl
eepl
essness.So,
iti
simpor
tantf
ort
he
nur
set
obewi
tht
hewomant
oreassur
eher
andhel
phert
o sl
eepbyusehy
pnot
ics
i
fshei
sinl
atentphase.
 Thenur
sehel
pst
hewomant
osl
eepby
pr
ovi
dingawar
m,nour
ishi
ngdr
ink,
mai
ntai
na
qui
etr
oom wi
thdi
mli
ght
ingandcomf
ort
abl
e
bed.
 Ambul
ati
onmaydecr
easet
heneedf
or
anal
gesi
cs,
shor
tenl
aboranddecr
ease
i
nci
denceoff
etal
hear
trat
eabnor
mal
i
ties.
 Thewomani
sal
l
owedt
oambul
atei
fther
e
ar
enocont
rai
ndi
cat
ionsasbl
eedi
ng,
PROM,
andmedi
cal
probl
ems.
 Massaget
hebacki
fshecompl
aint
sof
backache.

 Rel
i
evepai
nbyencour
agi
ngdeepbr
eat
hing
dur
ingcont
ract
ionanduseofanal
gesi
cs.

 Make dor
sif
lex
ion i
f cr
amps of her l
egs
occur
red.

5.Post
ureofwomani
nlabor
:
LI
I
 Thenur
seshoul
dal
l
owt
hewomant
oassume
anycomf
ort
abl
eposi
ti
on,
exceptt
hedor
sal
r
ecumbent

:
Car
eofbl
adder
 Encour
aget
hewomant
oev
acuat
ethebl
adder
ev
ery2-
3hour
sdur
ingl
abor
 N.
B:r
etent
ionofur
ineoccur
sfr
equent
lyi
n
l
aborduet
o;l
ackofmuscl
etoneoft
heur
inar
y
bl
adder
,uncomf
ort
abl
euseofbedpan,
pr
essur
eont
heur
ethr
aandel
ongat
ionoft
he
ur
ethr
a,whi
chi
nhi
bit
srel
axat
iont
heur
ethr
al
sphi
nct
er.

:
Obser
vesi
gnsofmat
ernaldi
str
ess
I
ncr
easedpul
ser
ateov
er100b/
min.
 El
evat
edt
emper
atur
emor
ethan38C.
 Decr
easedbl
oodpr
essur
e.
 Sweat
ingandpal
eface.
 Si
gnsofdehy
drat
ion.
 Dar
kvomi
ts.
 Ket
onebodi
esi
nur
ine.
I
rr
it
abi
l
ityandr
est
lessness.
 Anx
iousanddepr
essi
on.

Obser
vef
orcompl
icat
ion:
Power
:hy
pot
oni
corhy
per
toni
cut
eri
ne
cont
ract
ion.

LI
II
 Passenger
s:bi
ginf
ant
,mal
posi
ti
on,
and
mal
present
ati
on.
Passages:
CPD/cephal
opel
vi
c
di
spr
opor
ti
on,
cont
ract
edpel
vi
sand
r
igi
dcer
vix.

2.Fet
alAssessment:

Monitorandr ecor
dfet
alheartr
ate.I
tshoul
dbe
hear
dev ery2hoursunti
lrupt
ureofmembranes,
then
ever
y30mi nute

Obser
veandr
ecor
dsi
gnsoff
etal
dist
ress:
a.Excessi
vef
etal
mov
ement
.
b.Excessi
vemol
dingoff
etal
head.
c.Excessi
vef
ormat
ionofcaput
succedaneum.
d.I
ncr
easef
etalhear
trat
emor
ethan160b/
min,
ore.
decr
easel
esst
han100b/
min,orbecome
i
rr
egul
ar.
f
.Passageofmeconi
um i
ncephal
i
c
pr
esent
ati
on.

PostPr
ocedur
eTasks

1.Record al
lthe r
esul
ts and f
indi
ngs ofeach
procedur
euti
li
zi
ngpar
togram.
2.Repor
tforanymat
ernal
orf
etal
compl
i
cat
ions.

3.Clean, r
epack, and st
eri
l
ize al
lthe used
equipment.
4.Rest
oreandr
etur
nal
lthest
ock.

5.Tr
ansf
erwomant
othedel
i
ver
yroom:
LI
V
A-Pri
miparous:whent
hepr
esent
ingpar
tpul
ging
theperi
neum.
B-Multi
parous:whent
hecer
vixi
s
8-
9cm dilat
ed.
6.Washhands.

St
udentsi
gnat
ure:- Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

Vagi
nalexami
nat
ion

St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-
Pr
ocedur
e Done NOTDone
(
1)Washhand&ex
plai
npr
ocedur
etot
hewomen.
(
2)I
nst
ructwomant
oempt
yherbl
adderbef
ore
begi
nni
ngexami
nat
ion.
(
3)Pr
ovi
depr
ivacy

LV
(
4)Assi
stwomani
ntosupi
neposi
ti
ononexam t
abl
ewi
th
l
owerext
remi
ti
esf
lexedandr
otat
edout
war
d,herheel
s
shoul
dbesuppor
tedi
nst
ir
rup[
Lit
hot
omyposi
ti
on]
.
(
5)Assi
stt
hewomant
orel
axbyencour
agi
nghert
o
br
eat
henat
ural
l
y.
(
6)Exposet
hear
eaf
orexami
nat
ion.
(
7)Pr
epar
ethear
eawi
thant
isept
icsol
uti
on.
(
8)Putongl
oves,
from st
andi
ngposi
ti
onusi
ngt
humb&
f
oref
ingerofnon-
domi
nanthandt
ospr
eadt
hel
abi
a.

(
9)Separ
atet
hel
abi
awi
thy
ourgl
ovedf
inger
s.I
nspect
t
hegener
alar
eaof(
Vagi
nal
openi
ng)
.Andl
ookf
or:
-Amountofbloodyshow.
-Wet,gl
ist
eni
ngperineum.
-Deepyell
oworgreenishbrowndischar
ge.
-Freshmeconium.Incephali
cpresent
ati
on,
-Signsofinf
lammationorinf
ecti
on.
-Anyscars

(
10)I
nser
tthef
ir
stf
ingeroft
heot
herst
eri
l
egl
ovedhand
t
hent
hesecondf
ingergent
lyi
ntot
hev
agi
na.Thehand
shoul
dbet
urnedsi
deway
sint
hisi
nit
ial
step.

(
11)Keepdownwar
dpr
essur
easy
oui
nser
tthef
inger
s .
(
12)Thet
humbandf
oref
ingerononehandsepar
atet
he
l
abi
awi
del
y

LVI
(
13)Mov
eyourf
inger
sthef
ull
lengt
hoft
hev
agi
na
(
usual
l
y7.
5-10cm.
).
*Dur
ingt
heexami
nat
ion,
thef
our
thandf
if
thf
inger
s
shoul
dnott
oucht
her
ect
alar
eaandshoul
dbent
i
nwar
dandt
ouchi
ngt
hepal
m ofy
ourhand.
*Keept
het
humbst
rai
ghtupandst
ret
chedout
.
(
14)Not et hefol
lowing:
*Stateoft hevagina.
*Stateofcer vi
x,eff
acement
,anddi
l
atat
ion.
*Membr anes.
*Pr esentingpart
.
*Posi ti
on.
*Degr eeofmol ding.
*Caputsuccedaneum oranyabnormali
ties
*Stati
on
*Engagement

(
15)Swabt
hev
ulv
aor
if
ice.I
tisswabbedi
nther
ever
se
or
dert
hist
ime,
commenci
ngwi
thv
agi
nal
openi
ngt
hen
t
hev
est
ibul
eandf
ini
shi
ngwi
thl
abi
amaj
ora.I
fthe
membr
aneshav
erupt
uredpl
aceast
eri
l
epadov
ert
he
v
ulv
a.Tur
nthewomanont
oherl
eftsi
de,
dryt
heanal
r
egi
onandpul
lthr
ought
hesani
tar
ytowel
.Youmay
changet
hebedl
i
nen.
(
16)Makewomancomf
ort
abl
e.
(
17)Auscul
tat
ethef
etal
hear
tandl
ett
hewomanknow
howt
hingsar
epr
ogr
essi
ng.
(
18)Recor
dthef
indi
ngsont
hepar
togr
am.
LVI
I
(
19)Cl
earawayt
heequi
pmentandcl
eani
t.
(
20)Washhands.
Tot
alscor
e
St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

Managementdur
ingsecondst
ageofl
abor

St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-
Pr
ocedur
es Done NotDone

1-Checkgoodpl
acel
i
ght&pr
epar
eequi
pmenton
t
hedel
i
ver
ytr
oll
ey.

1-Putmot
heronl
i
thot
omyposi
ti
on

3-Ex
plai
npr
ocedur
etot
hemot
herandt
eachhert
o
beardowndur
ingcont
ract
ion&r
elaxi
nbet
ween.
4-Makecar
eful
Scr
ubbi
ng,
gowni
ng&gl
ovi
ng
Managementofsecondst
ageofl
abor
5-
Checkt
heFHRi
nbet
weencont
ract
ions
6-
Evacuat
emot
herbl
adderbycat
het
eri
zat
ion
7-
Per
for
m Per
ineal
car
e
8-
Ster
il
izat
ionwi
thbet
adi
neandputst
eri
l
etowel
9-
Drapi
ngt
hemot
her
10-
Del
iv
eryoff
etalhead Del
iv
eryoff
etalhead

LVI
II
Themai
ntaskofdoct
ori
stopr
eventper
ineal
l
acer
ati
onby
:
1-Bef
orecr
owni
ng:
suppor
tper
ineum byst
eri
l
e
dr
essi
ng.
2-Atcr
owni
ng:
doepi
si
otomy
:
-Gi
vet
hedoct
ort
hesy
ringeofl
ocal
anest
hesi
a
-Hel
pdoct
ori
npr
ovi
dingl
ocalanest
hesi
a
accor
dingpr
ocedur
e
3-Af
tercr
owni
ng:
appl
ypr
essur
eonper
ineum by
onehandandbackwar
dpr
essur
eonocci
putby
f
inger
soft
heot
herhand(
Rit
genmaneuv
er)
.
11-I
fheadi
sdel
i
ver
ed,
theey
eli
ds,
noseand
mout
har
egent
lyswabbedt
oremov
emucusand
bl
ood(
fet
alr
esusci
tat
ionst
art
sonceheadi
s
del
i
ver
ed.
Del
iv
eryofshoul
derandbody
12-
Whenant
eri
orshoul
derhi
ngesbel
owsy
mphy
sis
pubi
s,t
heheadi
sgent
lyl
i
ftedant
eri
orl
ytodel
i
ver
post
eri
orshoul
dert
henpost
eri
orl
ytodel
i
ver
ant
eri
orshoul
der
13-
Del
i
ver
yoft
her
emai
nderofbodyi
ssl
owl
y
ext
ract
edbygent
let
ract
iononshoul
derandhead
Af
terdel
iv
eryoff
etus
14-
Hol
dfet
usbyankl
eswi
thheaddown(
unl
ess
pr
eter
m babyorbabysuspectofi
ntr
acr
ani
al
hemor
rhage hol
dhor
izont
all
y.
15-
Clampi
ngf
ir
stKocheront
hecor
dfarf
rom t
he
LI
X
babyatl
east15cm t
henCl
ampt
heot
herKocheron
t
hecor
dfarf
rom t
hef
ir
stabout10cm
 I
fthecor
dist
ightar
oundt
hebaby
’sneck,
t
hedoct
orwi
l
lcl
ampt
hecor
dwi
tht
woar
ter
y
f
orceps,
placed3cm apar
t,andcutt
hecor
d
i
nbet
weent
het
wocl
ampscutt
hecor
dusi
ng
ast
eri
l
esci
ssor
s.
16-Ev
acuat
esmal
lsegment(
notmakemi
l
king)
,
Thencutt
hecor
dbet
ween2Kocherdownwar
d
usi
ngonedr
essi
ng

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

LX
 Managementdur
ingt
hir
dst
ageofl
abor

St
udentname: Gr
oup:
Dat
e Cl
ini
calar
eaoft
rai
ning:
-
Pr
ocedur
e Done NotDone

1-
Feel
thef
undust
oseei
fcont
ract
edornot
.
2-
Act
ivemanagementoft
hir
dst
ageofl
abor

Wehav
e2met
hods:
A-Conser
vat
iveMet
hod:
1.Putt
heul
narbor
deroft
hel
efthandj
ustabov
e
f
undus.
2.Wai
tunt
ilsi
gnsofsepar
ati
onappearanddescend
ofpl
acent
a
 Ut
erusbecomehar
der
,hi
gher
,gl
obul
ar,smal
l
er
andi
ncr
easedmobi
l
ityoft
heut
eri
nef
undus.
 Supr
apubi
cpl
ug.
 El
ongat
ionoft
hecor
d.
 Suddengushofbl
oodf
rom v
agi
na.
 Absenceoft
hecor
dpul
sat
ion.
3.I
mmedi
atel
y massage t
he f
unds oft
he ut
erus
t
hrought
hewoman’
sabdomenunt
ilt
heut
erusi
s
cont
ract
ed.
4.Askt
hewomant
ost
rai
n.
5.Aspl
acent
aappear
s,hol
ditby2handsandr
olli
t
gent
lyunt
ilt
hemembr
anesar
etwi
sted.

LXI
6.Gi
ve er
gomet
ri
ne (
met
her
gine) or sy
ntoci
non
(
oxy
toci
n)af
terdel
i
ver
yofpl
acent
a.
7.Sl
owl
ypul
ltocompl
etet
hedel
i
ver
yoft
hepl
acent
a
8.I
nspectand ex
ami
ne pl
acent
a and membr
anes
car
eful
l
ytobesur
enoneofi
tismi
ssi
ng.
B-Act
iveMet
hod(
Cont
rol
ledCor
dTr
act
ion)
1.Feelt
hef
undust
oseei
fcont
ract
edornot
.
2.Wi
tht
hedel
i
ver
yofant
eri
orshoul
der
,er
gomet
ri
ne
(
met
her
gine)i
sgi
ven.
3.Theut
erususual
l
ycont
ract
sst
rongl
yatonceaf
ter
del
i
ver
yoff
etusandpl
acent
asepar
ates.
4.Whent
heut
erushar
dens,t
hepl
acent
aisdel
i
ver
ed
by Br
andt
-Andr
ews met
hod (
Cont
rol
led Cor
d
Tr
act
ion)
.
5.Putt
hel
efthandonsupr
apubi
cregi
onandpush
ut
erus upwar
ds and by ot
herhand do gent
le
downwar
dsandbackwar
dst
ract
iononcor
datt
he
samet
ime.
6.Ver
ygent
lypul
ldownwar
dont
hecor
dtodel
i
vert
he
pl
acent
a.
7.Aspl
acent
aappear
s,hol
ditby2handsandr
olli
t
gent
lyunt
ilt
hemembr
anesar
etwi
sted.
8.Sl
owl
ypul
ltocompl
etet
hedel
i
ver
yoft
hepl
acent
a
9.I
nspectand ex
ami
ne pl
acent
a and membr
anes
car
eful
l
ytobesur
enoneofi
tismi
ssi
ng.
:
Exami
nat
ionofpl
acent
a
 Layoutt
hepl
acent
awi
tht
hef
etalsur
faceupper

LXI
I
 mostont
hedel
i
ver
ytr
oll
eyandnot
eshape,si
ze,
col
orandsmel
l
.
 Obser
vet
hef
etalsur
facef
ori
rr
egul
ari
ti
es.Usual
l
y
t
hef
etalsur
facei
swhi
te,shi
nyi
nnat
ure,smoot
h,
cov
ered wi
th amni
on and t
he umbi
l
icalcor
d
at
tachedneari
tscent
er.
 Obser
vet
hemembr
anesbyl
i
fti
ngt
hecor
dand
hol
ding t
he pl
acent
a up and i
nspect f
or
compl
eteness.
 Theamni
oni
sthenpul
l
edbackt
owar
dst
hecor
d,
t
her
ebysepar
ati
ngt
hemembr
anest
oensur
ethat
bot
har
epr
esent
.
 The pl
acent
aist
urned ov
er t
oinspect t
he
mat
ernalsi
de.
Themat
ernalsur
facei
sdar
kredi
n
col
orand i
smadeup of15 t
o 20 cot
yledons,
whi
char
esepar
atedbygr
oov
escal
l
edpl
acent
al
sept
a.
 Thecot
yledonsar
eexami
nedt
oensur
ethatt
hey
ar
eal
lpr
esent
,not
inganyar
easofi
nfar
cti
onor
bl
oodcl
ots
 Thecor
dist
henexami
nednot
ingt
hel
engt
h,t
he
poi
nt ofi
nser
ti
onandt
hepr
esenceofanyknot
s.
 Countt
hev
essel
sint
hecutendoft
hecor
d(2
ar
ter
iesandonev
ein)
;theabsenceofoneoft
he
ar
ter
iescanbeassoci
atedwi
thr
enal
agenesi
s.
3-
Uter
ineMassage
 
  
  
  
•Repeatut
eri
ne massage ev
ery15 mi
nut
esf
or

LXI
II
t
hef
ir
st2hour
stopr
eventr
iskofpost
par
tum
hemor
rhage.
 
  
  
  
• 
Ensur
ethatt
heut
erusdoesnotbecomer
elaxed
(
sof
t)af
terst
opi
ngut
eri
nemassage.
4-
Exami
nat
ionf
ort
ear
s
Exami
net
hewomancar
eful
l
y,r
epai
ranyt
eart
othe
cer
vixorv
agi
naandr
epai
repi
siot
omi
es.

LXI
V
5.Obser
vet
hewomancl
osel
yunt
ilt
heef
fectofI
V
sedat
ionhaswor
nof
f.
6.Moni
tort
hebl
oodl
ossandv
ital
signsev
ery15
mi
nut
esf
oranhourt
henev
ery30mi
nut
esf
oranhour
t
henev
ery1hourf
ort
henext4hour
sorunt
ilst
abl
e.
7.Pal
pat
etheut
eri
nef
undust
oensur
ethatt
heut
erus
r
emai
nscont
ract
ed.
8-
changet
hemot
hergownandputheri
ncomf
ort
abl
e
posi
ti
on.
Cont
inuei
nfusi
onofI
Vfl
uidsf
or4-
6hour
s.-
9
Wash,
rinse,
dryandr
epackal
lequi
pment
.-
10
Cont
inuemanagementoff
ort
hst
ageofl
aborand-
11
i
mmedi
atebabycar
e.

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

LXV
 Epi
siot
omy

St
udentname: Gr
oup:
Dat
e Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
e Done NoDone
1-washhandsandpr
epar
ethenecessar
y
equi
pment
.
2-Checkgoodpl
ace,
li .
ght
Putmot
heri
nli
thot
omyposi
ti
on.
-3
nd
I
dent
if
ysi
gnsof2 st
ageofl
abor
-4

Expl
ainpr
ocedur
etot
hemot
her
-5

6.Putonmask,
over
head&scr
ubbi
ng,
gowni
ng
&gl
ovi
ng.
7.Ar
rangeequi
pmentont
het
rayaccor
ding
sequenceofpr
ocedur
e.

8.Per
ineal
car
ewi
thant
isept
icsol
uti
on.

9.Dr
api
ngt
hemot
heraccor
dingpr
ocedur
e.

10-Ev
acuat
emot
herbl
adderbycat
het
eri
zat
ion.

LXVI
11-Foranest
hesi
a,i
tisnor
mal
tousel
i
docai
ne
ataconcent
rat
ionof0.
5%i
n10ml
,oratahi
gher
Topr
otectt
hef
etal
 concent
rat
ionof1%i
n5ml
.
head,
thenur
sewi
l
linser
ttwof
inger
sint
othe
v
agi
na,
whi
chshoul
dfol
l
owt
hepr
oposed
i
nci
sionl
i
ne.
12-Anest
hesi
ashoul
dbegi
veni
mmedi
atel
y
bef
orecr
owni
ngt
opr
ovi
desuf
fi
cientt
imet
o
begi
niti
sef
fect
,Dur
ingcr
owni
ng,
inser
ttwo
f
inger
sint
othev
agi
naandSi
ngl
ecl
eancut
(
appr
oxi
mat
ely3cm i
nlengt
h)i
smadei
n
oneoft
wodi
rect
ions:
*
*Medi
an:
ext
endi
ngdi
rect
lyf
rom t
hel
ower
v
agi
nal
bor
dert
owar
dst
heanus(
don’
treach
t
heanus)
.
*
*Medi
olat
eral
:ext
endi
ngdi
rect
lyf
rom t
hel
ower
v
agi
nal
bor
derdi
rect
lyt
owar
dst
hemot
hers'
r
ightorl
eft
.
13-
Ift
hewomanhasapr
evi
ousepi
siot
omyscar
i
tisbet
tert
oav
oidi
nci
si
ngt
heol
dscarasi
t
doesn’
theal
wel
l
.

14-
Repl
acet
hegl
oveswi
thanot
herst
eri
l
eone.

15-
Remov
eal
lcl
otsf
rom per
ineum.

LXVI
I
16-Car
eful
l
yexami
nef
orext
ensi
onsandot
her
t
earandr
epai
r

17-
Cov
ert
heepi
siot
omyi
nci
si
onwi
thst
eri
l
e
dr
essi
ng.

18-Makeper
ineal
car
e.

19-
Changet
het
owel
undert
hemot
her
.

Repai
rofepi
siot
omy

1-
Locat
etheapexoft
heepi
si
otomy
.
2-
Inser
tar
oll
ofswabsorapacki
ntot
hev
agi
na.
3-
Star
tsut
uri
ngatt
heapexoft
hewound,
close
t
hev
agi
nal
tearwi
thacont
inuousNo.
1orzer
o
cat
gutt
hensut
uri
ngt
hemuscl
esusi
ngcut
ti
ng
needl
e.

4-
Closet
hemuscl
eswi
thi
nter
rupt
edsut
ures
5-Sut
uret
heski
nlay
erusi
ngt
hecont
inuous
t
echni
que(
No.2or3cat
gut
)usi
ngr
ounded
needl
e.
6-
Inspectt
hewound,
remov
ethev
agi
nal
pack.

7-
Inser
taf
ingeri
ntot
her
ect
um t
oexcl
udeany
i
nvol
vement
.

8-
Cleant
hewoundandcov
eri
twi
thast
eri
l
e
pad.

LXVI
II
 PostPr
ocedur
eTasks:

1-
Makeper
ineal
car
e.
2-
Swabwi
thBet
adi
neont
heepi
siot
omysi
te

3-
Putast
eri
l
edr
essi
ngont
heper
ineal
area.

4-
Remov
eal
ltowel
sfr
om t
hemot
her
.

5-
Washhandsaf
tercl
eani
ngal
li
nst
rument
s.

6-
Repor
tacompl
etei
nfor
mat
ionabout
:
 -
Typeandsi
teofepi
si
otomy
.
 -
mountofbl
eedi
ng.
-
Ift
her
eisanyabnor
mal
i
ties

7-
Lif
tdownt
hemot
her
’sl
egsandmakeher
comf
ort
abl
e.

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

LXI
X
 I
mmedi
atebabycar
e
St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Done Not
Pr
ocedur
e Done
1-
Astheheadi
sdel
i
ver
ed,
themucusandf
lui
dar
ewi
ped
f
rom t
hei
nfant
’snoseandmout
hbyusi
ngdr
ygauzet
o
av
oidaspi
rat
ionoff
lui
dwi
tht
hef
ir
stbr
eat
h.
2-Gent
lenessandpr
event
ionofi
nfect
ion:St
eri
l
ity
mustbemai
ntai
nedusi
ngasept
ict
echni
ques
dur
ingandaf
terdel
i
ver
ytopr
eventcr
oss
i
nfect
ionf
rom ei
thert
hemot
herort
hedel
i
ver
y
r
oom.
3-
Suct
ion:
1)Washhands&weargl
oves
2)Recei
venewbor
ninwar
m bl
anketort
owel&pl
ace
underr
adi
antwar
mer
3)Pl
acenewbor
nint
rendLenBer
ghposi
ti
onwi
th
ext
endedhead.
4)Use smal
lrubber suct
ion cat
het
er t
oremov
e
aspi
rat
ionf
lui
dst
hatmayobst
ructai
rway
.
5)Suct
iont
henewbor
n’smout
hthennose.
6)Ox
ygenmaybegi
ven.
7)Av
oiddeepsuct
iondur
ingear
lymi
nut
e.

LXX
4-Pr
ovi
dewar
mthbykeepi
ngt
hebabydr
yfr
om any
amni
oti
cfl
uidandav
oidai
rdr
aft
sint
her
oom.

5-Gener
alphy
sical
exami
nat
ion:
1)Assesst
henewbor
n’scondi
ti
oni
mmedi
atel
yaf
ter
bi
rt
h at 1 mi
nut
e t
hrough Apgar scor
e and
compl
ete5mi
nApgarscor
e.
2)Measur
e t
emper
atur
e r
ect
all
y t
o excl
ude
i
mper
for
atedanus.
3)Per
for
m neur
ologi
calexami
nat
ion by checki
ng
commonr
efl
exesoft
henewbor
n.
4)Per
for
m gr
owt
h measur
ement i
ncl
ude l
engt
h,
wei
ght
, head ci
rcumf
erence and chest
ci
rcumf
erence.
5)Asses f
oranyabnor
mal
i
ty,congeni
taldef
ecti
n
head,
eyes,
ear
s,chest
,spi
ne,
face,
nose,
abdomen,
anusext
ernal
geni
tal
i
aandext
remi
ti
es.
6)Assesst
heski
nforscal
i
ng,wr
inkl
i
ng,bi
rt
hmar
ks,
l
anugohai
r,v
erni
xcaseosa,ski
ncol
orandr
asht
o
i
ndi
cat
e mat
uri
ty oft
he baby and excl
ude any
j
aundi
ceorabnor
mal
i
ties.

7)
Pal
pat
etheabdomenf
orear
lydet
ect
ionofanymass,
enl
argement
,congeni
talher
niaorswol
l
enor
gan(
li
ver
,
spl
een,
andki
dney
).

LXXI
 6-Cor
dcar
e:
1)Washhandsbef
oremani
pul
ati
ngcor
d.
2)Usest
eri
l
epl
ast
iccl
amporl
i
gat
ure,
thef
ir
stl
i
gat
ure
i
s pl
aced about2 i
nch f
rom t
he abdomen and
secondl
i
gat
urei
spl
acedabout1cm f
rom t
hef
ir
st
l
i
gat
ure.
3)Pr
essbet
weent
het
wol
i
gat
ures.
4)Cutt
hecor
dbybl
untst
eri
l
esci
ssor
.
5)Exami
neumbi
l
ical
cor
dtodet
ectanyabnor
mal
i
ties.
6)Pai
ntt
heendoft
hest
ump,bodyandsur
roundi
ng
ar
eaofcor
dwi
thal
cohol
70%.

7)
Don’
tcov
ert
hecor
dwi
thst
eri
l
egauze.
7-
Eyecar
e:
1)Washhand.

2)Cl
eant
heey
eli
dswi
thst
eri
l
ewar
m wat
er.

3)Wi
pef
rom t
henoseout
war
d.

4)Pul
ldown t
he l
owerl
i
d and i
nst
all1 dr
op of
ant
ibact
eri
alagentassol
uti
onofi
sophi
nicol
.

Li
disr
eleasedaf
ter2mi
nthenwi
pet
heexcesssol
uti
on
byst
eri
l
ecot
ton.
8-Pr
ovi
dei
dent
if
icat
ion band oft
henew bor
n whi
ch
pl
acedonwr
estorankl
eandi
ncl
udes(
mot
hername,
hospi
tal
no,
sex
,wei
ghtofnewbor
n).

LXXI
I
9-Taket
henewbor
n’sf
ootpr
int
sandt
hemot
her
’st
humb
pr
intaccor
dingt
othehospi
tal
pol
i
cy.

10-Admi
nist
erasi
ngl
edoseofv
itami
nKi
ntr
amuscul
ar.
11-
Wrapt
hebabyandgi
ftt
omot
her
.

12-Assi
stmot
hert
obr
eastf
eedi
fshedesi
res.Al
so
mai
ntai
nski
n-t
o-ski
ncont
act
.

13-Encour
aget
hemot
herf
orear
lybr
east
feedi
ng

14-Compl
etechar
ti
ng,
repor
ti
ngandr
ecor
ding.

15-Cl
eanandr
epl
aceequi
pmentaf
teruse.

16-Washhands.

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

LXXI
II
 Postnat
alcl
ini
calar
ea

Cl
ini
cal
obj
ect
ives:

1.Suppor
toft
hemot
herandherf
ami
l
yint
het
ransi
ti
ont
oanew f
ami
l
y
const
ell
ati
on,
andr
esponset
othei
rneeds.
2.Pr
event
ion,ear
lydi
agnosi
sandt
reat
mentofcompl
i
cat
ionsofmot
her
andi
nfant
,incl
udi
ngt
hepr
event
ionofv
ert
icalt
ransmi
ssi
onofdi
seases
f
rom mot
hert
oinf
ant
3.Ref
err
alofmot
herandi
nfantf
orspeci
ali
stcar
ewhennecessar
y
4.Counsel
i
ngonbabycar
e
5.Counsel
i
ngonmat
ernal
nut
ri
ti
on,
andsuppl
ement
ati
oni
fnecessar
y
6.Counsel
i
ngandser
vicepr
ovi
sionf
orcont
racept
ion,
bir
thspaci
ngandt
he
r
esumpt
ionofsexual
act
ivi
ty.
Thr
oughcl
ini
calt
rai
ningt
hest
udentwi
llbeabl
eto:

1.Demonst
rat
esoundsci
ent
if
icknowl
edge&under
standi
ngdeal
i
ngswi
th
t
hemot
her
s&t
hei
rfami
l
ies.
2.Demonst
rat
eski
l
lsi
npost
nat
alassessment
.

3.Demonst
rat
eski
l
lsi
nident
if
yingt
heneeds&pr
obl
emsof postnat
al
mot
her
s&neonat
es.

4.Demonst
rat
eabi
l
ityt
oimpl
ementt
hepl
annedcar
etopostnat
almot
her
s
&neonat
es.

5.Per
for
m ut
eri
nemassagef
orpostpar
tum mot
her
.

6.Demonst
rat
eper
ineal
car
eforpostpar
tum mot
her

7.Ev
aluat
eper
ineal
condi
ti
onf
orpostpar
tum mot
her
.
LXXI
V
 8.Pr
ovi
denur
singcar
eaccor
dingt
othepr
ior
it
yofneedsdur
ingpostnat
al
per
iod.

9.Pr
ovi
der
out
inecar
efornewbor
n.

10. Pr
ovi
decasepr
esent
ati
onandmot
hercl
ass.

Post
par
tum Ev
aluat
ionsheet

I
temsofev
aluat
ion Tot
al St
udent Comment
mark mar k
Per
sonaldi
gni
ty:
- Absent
eeism 9
- Organi
zat
ion 1
- Grooming 1

Af
fect
iveDomai
n:-
- Relationshi
pwi
thpat
ient 1
- Staff. 1
- Colleagues. 1
- Behav ior
. 1

Appl
i
cat
ionofnur
singpr
ocess 5

Assessmentsheet 5

Mot
hercl
ass 3

I
ntel
lect
ualDomai
n:

- Or
alexam. 10
- Wri
tt
enexam. 10

Psy
chomot
orDomai
n:-

- Fourt
hstageoflabor 3
- Fundusandlochia 3
assessment 2
- Peri
nealcar
e 2

LXXV
 - Breastcar
e 2
- Pelvi
cExaminat
ion

Tot
al 60

St
udent
'ssi
gnat
ure:- I
nst
ruct
or'
ssi
gnat
ure:
-

Postnat
alr
ecor
d
Mot
her
`sname:
- par
it
y:- age:
-
Met
hodofdel
iv
ery
: dat
eofdel
iv
ery
:-

Date V.
S. Ut
erus Lochi
a Br
east Mother Out Int
ake I
nvest
igat
ion
-
ti
me general put
condit
ion

LXXVI
 Babyr
ecor
d
Mot
her
'sname: babysex: gest
ati
onalage:
Dat
eofdel
iv
ery: wei
ghtaf
terdel
iv
ery
: Ti
meofdel
iv
ery
:
Date V.
S. St
ump General Feedi
ng Output Ngcar
e
-
ti
me condit
ion

LXXVI
I
Gl
ossar
yofPost
par
tum per
iod:

 I
nvol
uti
on:

 Subi
nvol
uti
on:

 Ut
eri
neat
ony
:

 Lochi
a:

 Lochi
aAl
ba:

 Loci
arubr
a:

 Loci
aser
osa:

 Af
terpai
ns:

 Puer
per
ium:
LXXVI
II
 Managementdur
ingf
our
thst
ageofl
abor

St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
e Done NotDone

Pr
e-pr
ocedur
epr
epar
ati
on:
1.Pr
epar
eal
lrequi
redequi
pment
.

2.Pr
epar
eandchanget
hemot
her
’scl
othes(shoul
dbe
col
orf
ul,
wideenough,
andeasyt
oopenatbr
eastar
ea

3.Per
for
m handwashi
ng,
handr
ubbi
ngwi
thal
cohol
and
wearongl
ovesi
fav
ail
abl
e.

4.Expl
aint
hepr
ocedur
etot
hewoman

LXXI
X
5.Tr
ansf
ert
hewomanf
rom t
hedel
iv
eryr
oom t
orecov
ery
.
room oncl
eant
rol
l
eyf
orcont
inuousobser
vat
ion

-Assi
stt
hewomant
omov
efr
om t
het
abl
etot
hebed(use
neckkneet
echni
que)

-Encour
aget
hewoment
ohav
ecomf
ort
abl
eposi
ti
on(
semi
-set
ti
ngi
spr
efer
red)
.

.
6.Moni
tort
hewoman’
svi
tal
signsandgener
alcondi
ti
on

Assess(BP,
P,TandRev
ery15mi
nut
esf
oranhour
,then
ev
ery30mi
nut
esf
oranhour
,andt
henev
eryhourasl
ong
ast
hewomani
sst
abl
e.

.
7.Checkut
eri
net
oni
cit
y
-
Fundall
evel
:Pl
acecuppi
ngonehandagai
nstt
hel
ower
ut
eri
nesegment(
justabov
ethesy
mphy
sispubi
s),
then
usegent
lyt
hesi
deoft
heot
hercuppedhandt
opal
pat
eat
t
heumbi
l
icust
owar
dthesy
mphy
sispubi
sunt
il
det
ermi
ningt
hel
ocat
ionoft
hef
undus.(
Immedi
atel
yaf
ter
del
i
ver
yfundal
lev
elatt
hel
evel
ofumbi
l
icusorabov
eby
onef
inger
,af
teroneweek,
fundal
lev
eli
nthemi
dway
bet
weent
heumbi
l
icusandsy
mphy
sispubi
s,af
tert
wo
weeksf
undal
lev
elatt
heupperbor
derofsy
mphy
sis
pubi
s).

Pal
patethefundus:usi
ngf l
atpadoff
ourfi
ngerto-
det
erminei
ffunduscontracted(f
ir
m)orl
ax(boggy)
.
-Massagethefunduswithdominanthand,i
ncircul
ar
moti
onunti
ltheuterusbecomescontract
ed(insame
.
dir
ecti
onofclock)
.
LXXX
Ut
eri
neposi
ti
on:nor
mal
posi
ti
onont
hemi
dli
newhent
he-
bl
adderi
sempty
.
Uter
usmaydevi
atestori
ghtorl
eftf
rom t
hemi
ddl
ewhen
thebl
adderi
sdi
stendedwit
huri
ne.

8.Moni
torl
ochi
afl
ow:
-Lochiai
sthevagi
naldi
schargeofbl
ood,
mucus,
and
.
tissuefr
om t
hepuerper
aluterus
Thi
smayl
astf
or2weeksaf
terbi
rt
h

I
nit
iat
eI.
Vli
net
omai
ntai
nst
ateofdehy
drat
ionf
orf
ir
st-
9
t
wohour
spost
par
tum.

Discont
inueIVonanor
malwomanonceshei
sst
abl
eand-
.
thephysici
anhasor
der
edr
emoval
.
10-Obser
vewoman’
sur
inar
ybl
adderf
ordi
stent
ion
Encouragethewomant opassurinefr
equentl
yasf ul
l
bl
adderpreventst
heuterusfr
om contract
ingappropr
iat
ely
.
causinguteri
neatonyandpostpart
um hemorrhage
:
Char
act
eri
sti
csofaf
ullbl
adder
-
 Bulgi
ngofthelowerabdomen.Spongymass
betweenthefundusandthepubis.
 Displ
aceduterusfr
om t
hemi dl
ine,
usual
l
ytot
he
ri
ght.
Increasedlochiaf
lowduetoatony.

LXXXI
11-Assesst
hegeni
tal
andper
ineal
area:
-
Assessmentforper
ineal
hemat
oma(
discol
orat
ion)
,pai
n
orl
acerat
ion
:
REEDAscal
e-
Isascal
eusedinthepostpar
tum caret
ogradeheali
ngof
per
inealt
raumaassoci
atedwithl
acerat
ionorr
epairof
epi
siot
omyassociat
edwi t
hdeli
very
R--
-redness.E-
--edema.E-
--ecchymosis.D-
--dischar
ge.A-
--Appr
oximationofedges.
12-Promotingearlyf
amil
yattachment:
-Thef i
rsthouraf
terbi
rt
hisi
dealforpar
ent
-i
nfant
attachmentbecausetheheal
thyneonat
eisal
ertand
responsive.
Encouragethewomant
oputherbabyonbr
eastassoon-
aspossibl
e.
-
obser
vet
hemot
her
-i
nfanti
nter
act
iondur
ingl
act
ati
onand
women'
sresponset
owar
dherbaby
'scr
ying.

13-Encour
ager
estandsl
eep:
-
Maint
ainqui
te,
cleanenv
ironmentt
hathel
prest
,pr
ovi
de
war
m dri
nk.
14-Pr
omot
ingcomf
ortbysi
mpl
emeasur
esas:
-I
cepacks.Applyani
cepackt
otheper
ineum pr
ompt
ly
af
terv
aginalbi
rt
h.
-Anal
gesi
cs:Af
terpai
ns(ut
eri
necont
ract
ion)andperi
neal
.
painr
espondwellt
omildoral
anal
gesi
cseffect
ivel
y
-Warmt
h:Awar
m bl
anketshor
tenst
hechi
l
lcommonaf
ter
bi
rt
h.

LXXXI
I
15-I
nst
ructt
hewomanabout
:

 Per
inealcar
e:i
nst
ructwomen t
ofol
l
ow per
ineal
car
etechni
que af
ter di
schar
ge use ant
isept
ic
sol
uti
oncl
eanper
inealar
eaf
rom upt
odownwi
th
war
m wat
erand ant
isept
ic sol
uti
on,change t
he
per
ineal
padev
ery4hour
sorasneeded.

 Epi
siot
omycar
e:byant
isept
icsol
uti
onandcov
eri
t
wi
thst
eri
l
edr
essi
ng

 Br
eastcar
e.

 Br
eastf
eedi
ng

 Babycar
e(ey
e,cor
d,ski
nanddi
apercar
e).

 Fami
l
ypl
anni
ng:att
heendofpuer
per
ium cont
act
y
ourdoct
orf
orcounsel
i
ngaboutt
heappr
opr
iat
e
met
hodoff
ami
l
ypl
anni
ng.

POST-
PROCEDURETASKS:

16-Col
lectandr
emov
etheequi
pment
.

17-r
emov
egl
ovesandwasht
hehands

18-
Compl
etet
her
ecor
dofdat
aforwomanandi
nfant
. .

19-Tr
ansf
ert
hewomant
othepost
nat
alwar
dift
her
eis
noanyabnor
mal
it
ies

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

LXXXI
II
 Per
ineal
car
e

St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
e Done NotDone

1.Gat
herallr
equiredequipmentandar
rangei
t
accor
dingtopri
ori
t yofuse.
2.Explai
ntheproceduretothewoman.

3.Askt hewomant oemptythebl

adderi
fsheneeds
(usi
ngt oi
let
,bedpan,
ortemporar
y
catheteri
zat
ion)
.

4.Cl
oset
hedooroft
her
oom andpl
acet
hebedcur
tai
n
5.Per
for
m handwashi
ngandwearonst
eri
l
egl
oves
6.Rai
set hebedtoy ourwaistl
evelandremoveorl
ower
bedsiderail
sinfrontofyou.
7.mai
nt ai
nproperpositi
on:
-putdisposabl
ewat erpr
oofsheetbeneathwomenuse

LXXXI
V
fol
lowi ngst eps:
1)Cov erthewomanwi t
hcov ersheetorl inen.
2)Tur nwoment ol eftsi dely i
ngposi tionuseneck-
kneet echni que.
3)Thesol idsheetr olledoutt owar dwomenbodyand
newsheetappl i
edwi thf oldf acingy out ucki tunder
womenbody .
3)Assi stt hemot hert ol ieindor sal r
ecumbentposi ti
on
withherkneesl ight l
ybentandl egsopened.Putpi ll
ow
underwomanhead.
4)Car efullyr emov esol i
dsheetandadj ustnewone
undert hewomenbut tock.
5)Uncov ert hewoman' sper i
neal areaf rom umbi l
icus
toknee( thecov erdownandgownup) .
-Avoidex poseun- necessar yar ea.
8.Remov et hesol idper ineal padordr essingf rom upt o
downwar d( fr
om f r
ontt oback)wi thoutwi pi
ngt he
genitaliawi thsol idpad.
9.Obser vecol or ,type, amountandodorofl ochiaon
thesol idpadbef oredi scar dit.
10.Rol lsoi l
edpadwi thgl ov es&di scar ditinpaperbag.
Wraphandswi thal cohol orant isept ichandwashi nglet
handsdr yandputonst eril
egl ov es.
11.Pr epar ewar m wat erandt estitwi thy ourel bowor
wristandaskwoment ot estt hewat ert emper atureby
putherhandi nt hebasi norpourdr opsofwat eron
womanwr ist.
12.Cl eant heMonspubi sf r
om cl i
torislev elupwar dto
l
owerabdomenusi ngzi gzagmot i
on.
13.Cl eani nt ernal aspectoff arestt highf rom insideto
outsideoft het hight owar dkneeusezi gzagmot ion.

14.Cl eanfarestlabiamajorafr
om upt odown.
15.Cl eanl
abi ami noraandvesti
bulefr
om uppertoward
rectum usingcot tonsponges
16.Cl eannearestl abiamaj
orafrom uptodown.
17.Cl eani
nt ernalaspectofnearestt
highfrom i
nsidet
o
outsideoft het hi
ght owar
dkneeusezi gzagmot i
on.
18.Cl eanther ectum usi
ngcottonsponge.
19.Pourt her estoft hesol
uti
onov ert
hev ulv
aand

LXXXV
per
ineum

20.Ri nse and dr yt he per ineum usi ng the same

technique.Usecl eanwashcl othesforr i
nse
21.Assistwoment ot ur nont osideawayf r
om nur se
useneckkneet echniqueanddr ythebutt ocks.
22-Assesst heper ineum af terthepr oceduref orany
signsofhemat omaori nf
ectionaccor dingt oREEDA
(Redness, Ecchy mosi s, Edema, Di scharge, and
Approximati
onoft heedges)scal eforincisi
on.Obser ve
anusf orhemor rhoid.Putst er i
leperi
nealpadov erthe
perineum wi thouttouchingi t
ssur face.
23.Helpthewomant ofindacomf ort
ableposi t
ion.

24.Remov
esuppl
i
esandcl
eanequi
pment
. .
25.Removegl
ovesandper
for
m handwashi
ng.And
recor
dfi
ndi
ng

St
udentsi
gnat
ure Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

Fundsandl
ochi
aassessment
St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-
Pr
ocedur
e Done NotDone
1.Gat
heral
lrequi
redequi
pment
.ar
range
equi
pmentaccor
dingt
oor
derofuse
2.Ex
plai
nthepr
ocedur
etot
hewoman.

LXXXVI
3.Encour
aget
hewoment
ovoi
dbef
oret
he
pr
ocedur
e(usi
ngt
oil
et/
bedpan/
ort
empor
ary
cat
het
er)
.
4.Per
for
m handwashi
ngandwearongl
ovesi
f
av
ail
abl
e
5.Cl
oset
hedooroft
her
oom andpl
acet
he
scr
een
6.Rai
set
hebedt
oacomf
ort
abl
ehei
ghti
f
possi
ble.Remov
eorl
owersi
der
ail
inf
rontof
y
ou.
1.putwomanonsui
tabl
eposi
ti
on:

-askt
hewomant
oli
eonherback,
uncov
er
abdomenandhav
ethekneessl
i
ght
lybent
.
8.st
andatt
her
ightsi
deoft
hewomanbed
9.Lowert
heper
ineal
pad/i
fthepadsat
urat
ed
r
emov
eitandputcl
eanoneunderwoman
but
tock.
10.Pl
acecuppi
ngofr
ighthandagai
nstt
he
l
owerut
eri
nesegment(
justabov
ethesy
mphi
s
pubi
snotont
hebone)
.

LXXXVI
I
11.Usegent
lyt
heul
narboar
deroft
hel
eft
handt
odet
ermi
net
hel
ocat
ionoft
hef
undus
(
pal
pat
einwar
dtowar
dspi
neunt
ill
ocat
ethe
f
undus)
.
13.Det
ermi
nesi
ze/
shapeshoul
dber
egul
ar
andsy
mmet
ri
cal
mobi
l
e,f
ir
m andwel
l
cont
ract
ed/l
ocat
edi
nthemi
dli
nebel
ow
umbi
l
icus.
14.Massaget
heboggy/sof
tut
erususi
ngt
he
f
latpar
toft
hef
inger
soft
hedomi
nanthand
unt
ilt
heut
erusbecomecont
ract
edandf
ir
m

1)Obser
vet
hecol
or,
odor
,consi
stency
,and
amountoft
hel
ochi
aint
hepad.

2)Per
for
m per
ineal
car
e.

3)Tur
nwoment
olef
tsi
deobser
veper
ineum
f
orhemor
rhoi
dedemaecchy
mosi
sandC.
S
sut
ureheal
i
ngi
fepi
siot
omyper
for
meduse
REEDAscal
e.

4)Swabepi
siot
omysi
tewi
thBet
adi
ne.Cov
er
epi
siot
omywi
thst
eri
l
edr
essi
ng.

10.Useanewper
ineal
padt
ocov
ert
he
per
ineum af
terper
ineal
car
e.
20.Hel
pthewomant
ofi
ndacomf
ort
abl
e
posi
ti
on.
LXXXVI
II
21.Remov
egl
ovesandper
for
m handhy
giene
22.Documentappr
opr
iat
elyal
lthef
oll
owi
ng:
-Ti
mingoff
undusandl
ochi
aassessment
.
-col
or,
odor
,amount
,andconsi
stencyofl
ochi
a
-condi
ti
onoft
hef
undus

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

Br
eastCar
e

St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
e Done Notdone

Washhands

Assembl
e al
l r
equi
res
equi
pment
s
Expl
aint
hepr
ocedur
etot
he
women
Scr
eent
hewomen

Putt
hewomeni
nsi
tt
ingorl
i
e
downposi
ti
on.
LXXXI
X
Exposet
hebr
east
s

Pl
ace t
he wat
erpr
oofsheet
underbr
east
s

Obser
ve and i
nspect t
he
br
east
s(si
ze,shape,cont
our
,
col
or,ni
ppl
e col
or,di
rect
ion
and si
ze) compar
e t
wo
br
east
sforsy
mmet
ri
cal
l
y.
Cl
eanbr
eastwi
thwar
m wat
er
and cot
ton i
n a ci
rcul
ar
mov
ementst
artf
rom ar
eol
a,
br
eastt
oendoft
heax
il
la.
Washt
hebr
east
swi
thsponge
cl
othl
i
keabov
est
ep
Cl
eant
heni
ppl
esandr
emov
e
al
lthe cr
ust
s wi
th cot
ton
swab
Expr
essl
i
ttl
emi
l
k

Check f
or cr
acks and
i
nver
sion of ni
ppl
es or
engor
gementoft
hebr
east
s
Dr
ythebr
east
swi
tht
owel


XC
 Putt
hebabyont
hebr
east
s
butbef
oreput
ti
ngt
hebabyt
o
br
east
,any di
schar
ge f
rom
baby
’sey
esornosei
stobe
cl
eaned, napki
n must be
changed
Appl
ylubr
icantt
oni
ppl
esas
needed
Adv
isehert
owearsuppor
ti
ng
br
a
Cov
ert
hemot
her
`sbr
east

Di
scar
d paper bag wi
th
wast
es
Wash hands and r
ecor
d
obser
vat
ion

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

Pel
vi
cExami
nat
ion

St
udentname: Gr
oup:
Dat
e: Cl
ini
calar
eaoft
rai
ning:
-

Pr
ocedur
e Done NotDone
1.Gr
eett
hewomanandmakeherf
eel
atease

2.I
nst
ructt
hewomant
oempt
ybl
adder&
t
oundr
essf
rom t
hewai
stdown

XCI
 3.Gi
veherasheett
opl
acear
oundher&ask
hert
osi
tont
heendoft
het
abl
e

4.Expl
aint
hepur
poseofpel
vi
cexami
nat
ionby
:

*
Descr
ibet
hepr
ocedur
eandwhatt
hewoman
wi
ll
feel

*Showt
hewomant
heequi
pmentt
hat
wi
l
lbeused
5.Assi
stthewomani nt
otheli
thot
omyposi
ti
on
fort
heex aminat
ion,
makinghercomf
ort
abl
e
aspossible

6.Putt
hewomani
ncor
rectposi
ti
onby

*pl
aceawedgeundert
hewoman’
sri
ghtor
l
efthi
ptomai
ntai
nasl
i
ghtl
ater
alt
il
t
*El
evat
eherhead&shoul
der
ssl
i
ght
ly
*Putherar
msr
estei
therathersi
deoronher
chest
*Posi
ti
onherbut
tocksatt
hebot
tom oft
he
t
abl
e
*pl
aceherf
eeti
nthest
ir
rups,
wit
hherl
egs
wi
deapar
t
*Dr
apet
hesheetov
erherf
rom t
hewai
st
down
7.Encour
agethewomantomai
ntai
nrel
axedby
doslow–pacedbr
eat
hing

8.Of
ferherami
rr
ori
fshewoul
dli
ket
oobser
ve
t
hepr
ocedur
e

9.I
nfor
mthewomanaboutwhatt
oexpectat
XCI
I
 eachpoi
ntoft
heex
ami
nat
ion(I
nspect
ionof
t
heex
ter
nal
geni
tal
i
a,specul
um exami
nat
ion
,
bimanual
exami
nat
ion&assessmentoft
he
bonypel
vi
s)

10. I
nst
ructhert
obeardownas
t
hespecul
um i
sbei
ngi
nser
ted

11. Washhandsandputongl
oves
bef
orehandl
i
ngspeci
mens

12. Assi
stt
hewomant
oasi
tt
ing
posi
ti
on,
assur
ingt
hatsher
emai
nscov
ered
wi
tht
hesheet
.

13. Of
ferherat
owel
towi
pe
l
ubr
icantf
rom t
heper
ineal
area

14. Pr
ovi
depr
ivacyasshedr
esses

15. Gi
vi
ngt
hewomanan
oppor
tuni
tyt
oaskmor
equest
ionsaf
ter
exami
nat
ion

16. Repl
aceequi
pment

17. Washhands

St
udentsi
gnat
ure: Cl
ini
cali
nst
ruct
orsi
gnat
ure:
-

XCI
II
XCI
V