CALAMBA DOCTORS’ COLLEGES

Parian, Calamba City, Laguna

Performance Evaluation Checklist

Name: ________________________ Date: _______________

Year and Section: _______________

Instruction: Rate the nursing skill performance of the student based as follows: 5 = Perfect (91-100), 4 = Very
Satisfactory (85-90), 3 = Satisfactory (80-84), 2 = Poor (79-75), 1 = Need Improvement (74 and below)

Measuring Fundic Height

Preparation 5 4 3 2 1 Comments
1 Explain to the client what you are going to do, why it is necessary,
and how she can cooperate
2 Wash hands and observe other appropriate infection control
procedures
3 Provide for client privacy. Drape the client accordingly.
4 Uncover the woman's abdomen.
Equipment.
Tape measure
Sheet (for draping).
Procedure
1 Place the client in supine position. Ensure she is relaxed and
adequately positioned.
2 Place the end of tape measure at the level of symphysis pubis.
3 Stretch tape to the top of the uterine fundus
4 Fundic height is measure in centimeter which should be
approximately equal to the week gestation.
Greater Fundic Height Indicates
A. Multiple pregnancy
B. Miscalculated due date
C. Polyhydramnios
D. Hydatidiform mole
Lesser Fundic Height Indicates
A. Fetal growth rate retardation
B. Fetal death
C. Error in estimating AOG
D. Oligohydramnious
5 Provide opportunities for the woman to ask questions and express
concerns
6 Document assessment findings according to agency policy
Ave. Score =

Grade: __________
Evaluated by:

__________________________
Clinical Instructor

https://www.youtube.com/watch?v=nyfUh5zlB1U