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LEOPOLD'S MANEUVER
Christian Gerhard Leopold-Gynecologist

systematic method of observation and palpation to determine fetal presentatio

n and position.

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VAGINAL EXAMINATION

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VAGINAL EXAMINATION

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· Color
· Amount
· Odor
· Time of rupture

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Labor and birth are natural processes, so the average woman should be able t
o complete labor and birth without assistance form medical interventions.

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NURSING DIAGNOSIS: Powerlessness related to duration of of labor
OUTCOME EVALUATION: Patient voices she feels in control of happening, ep
xress preferences for positions and techniques to control of pain, ask question
s about her progress, and states feeings about what is happening.

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NURSING DIAGNOSIS: Risk of ineffective breathing pattern related to breathi
ng exercises
OUTCOME EVALUATION: Patient voices she feels in control of happening, ep
xress preferences for positions and techniques to control of pain, ask question
s about her progress, and states feeings about what is happening.

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NURSING DIAGNOSIS: Anxiety related to stress of labor
OUTCOME EVALUATION: Patient states she feels in control of situation; she
and her support person express confidence in their ability to to weather this ext
raordinary event in their life.

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NURSING DIAGNOSIS: Risk for fluid vloume deficit related to prolonged lack
of oral intake and diaphoresis from the efort during labor
OUTCOME EVALUATION: Patient drinks at least one glass of selected bevera
ge every hour; states she does not feel thirsty; voids at least 30ml/hr every 2 to
4 hrs.

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NURSING DIAGNOSIS: Anxiety related to stress of labor
OUTCOME EVALUATION: Patient states she feels in control of situation; she
and her support person express confidence in their ability to to weather this ext
raordinary event in their life.

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Water Birth Considerations:
· keep the water clean and warm
· tub should be cleaned with agency-designated solution
· limit water in the tub to about 12 inches.

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EPISIOTOMY

· An episiotomy is a cut (incision) through the area between your vaginal openin
g and your anus. (perineotomy)

· This procedure is done to make your vaginal opening larger for childbirth.

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· Ritgens Maneuver was defined as an upward pressure from the coccygeal regi
on to extend the head during vaginal delivery. (often unnecessary)
· pressure should never be applied to the fundus of the uterus (risk for uterine ru
pture)
· Push until the occiput of the fetal head is firmly at the pubic arch

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· Check for nuchal cord, it should be loosened and drawn down over the fetal h
ead.

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· Follow EINC Guidelines
* Delayed cord clamping and cutting

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42 Classification of Perineal Laceration

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44 Immediate Postpartum Assessment and Nursing Care

· Assess Contraction
· Vital signs q15 mins (for the 1st hour then according to agency policy)
· Assess fundus size, consistency and position
· Perineal Care
· Observe amount and characteristics of lochia,

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