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 toePresent/Past History:

Menarche, Interval of Menstruation

Length

Recent birth control or lactation

LMP -Sure of date?

- Normal in length & flow

Other signs and symptoms:

Date of conception

ER sonogram

Serious illnesses

Any Hospitalizations

Any Surgery

Drug allergies or unusual reactions

What are the Medication taken since LMP

Obstetrical History:

Dates of all pregnancies (include previous

miscarriage or termination)

GA

Gender, weight

Length of labor

Coping techniques

Route of delivery

Special events AP, IP, PP, Neo

Gynecological History:

Last Pap

Abnormal pap

Gyn surgery or problems (e.g.

infertility)

Family planning methods

Sexually transmitted infections

Family History

Maternal

Diabetes

CAD

Pre-eclampsia

Preterm delivery

Cancers (breast, ovarian, colon)

Depression, bipolarity

Twins

Anesthesia reactions

Maternal or Paternal

Birth defects

Mental retardation

Bleeding disorders

Chromosomal abnormalities

(e.g. Dpwn Syndrome)

Prenatal Care: What are the vital signs?

-Temperature, Pulse Rate, Respiratory Rate, BP

What are the measurement of the Patient?

-Height -Weight

Any Observations?

-Clubbing – caused by chronic hypoxia

-Lines coincide with periods of acute illness or

stress. Caused by disruption of nail

plate growth.

-Koilonychia Spoon-shaped nails, a Chronic

iron deficiency anemia

-Cyanosis of nail beds

-HEENT – Lymph Nodes

-The mouth (B vitamin deficiency, Fungal infections

and Over-biting, Gingivitis of pregnancy

-Geographic tongue

-Superficial Nasal Sinuses

-Eyes

Cont.-Chalazion (plugged sebaceous gland)

-Conjunctivitis – viral

-The eyes – icterus

-The Neck:

1. thyroid (watch for any s/s:)

a. Hypothyroid

-Cold intolerance, slow pulse, thin, dry hair &

dry, puffy skin, Fatigue, thick tongue,

delayed relaxation of Achilles reflex

b. Hyperthyroid

-Heat intolerance, Rapid pulse,

Flushed, sweating, Anxious,

Fine tremors, Exaggerated reflexes

-The Chest, Breast and the cardiac cycle

-The Back

-Auscultation of the lungs

*Normal breath sounds, Crackles,

Rhonchi, Wheezes

- Abdominal assessment

-Inspect abdomen for contour, asymmetry,

scars, rashes, or other lesions

-Listen for bowel sounds present, increased,

decreased, absent, high-pitched

-Light palpation for tenderness most sensitive

indicator is facial expression, voluntary or

involuntary guarding may also be present

-Deep palpation for masses

-Deep tendon reflexes and check for edema

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 thatmoves 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 Gripa. 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!