Pregnant Exam
🛑 👉🏻👉🏻👉🏻 INFORMATION AVAILABLE CLICK HERE👈🏻👈🏻👈🏻
Возможно, сайт временно недоступен или перегружен запросами. Подождите некоторое время и попробуйте снова.
Если вы не можете загрузить ни одну страницу – проверьте настройки соединения с Интернетом.
Если ваш компьютер или сеть защищены межсетевым экраном или прокси-сервером – убедитесь, что Firefox разрешён выход в Интернет.
Время ожидания ответа от сервера www.clearblue.com истекло.
Introduction
Positioning and exposure
Equipment
Inspection: Hands
Inspection: Face
Inspection: Abdomen
Symphysis-fundal height
Foetal lie
Foetal presentation
Foetal engagement
Auscultation
Completing the examination
Interactive markscheme
Knowing what to say in a pregnant abdominal examination is important. Here are a few recommended phrases:
“I have been asked to perform an examination of your tummy (can also say ‘baby bump’) today. Have you had one before? Do you understand what it involves?”
“In this examination, I will be taking a few measurements of your tummy and feeling to see which way the baby is facing. The examination should not be painful but it may feel slightly uncomfortable. I will use a special stethoscope to listen to the baby’s heart.”
We measure using the tape measure face down in order to avoid any bias. This distance should correlate with the gestational age +/- 2cm .
There are a few key points to know about the fundus that will help you predict the gestational age of the foetus. At 12 weeks gestation , the fundus is normally at the level of the pubic symphysis . At 20 weeks , it is found at the umbilicus . At 36 weeks , it is found at the xiphoid process of the sternum.
When assessing each other, click on each list item as you go along. Doing so will turn the list item green. Make careful note of any steps missed at the end.
We recommend completing any examination or procedure in under 10 minutes, but you can adjust the timer to suit your needs.
Introduce yourself, confirm the patient's name, date of birth, and gestational age. Ask the patient if the pregnancy is single or multiple.
Ask if they have had a pregnant abdominal examination before and whether they understand what it involves. Explain the purpose of today’s examination and obtain consent . Inform them that the examination may be slightly uncomfortable. Ask the examiner to act as your chaperone. Ask the patient if they would like to empty their bladder before beginning.
Ask the patient to lie supine on the bed set at 15° ; this is to reduce the risk of aortocaval compression. Next, ask them to uncover their abdomen. They will need to be completely exposed from the xiphisternum to the pubic symphysis . You may the curtains to give the patient privacy as they get ready.
Whilst the patient is positioning themselves on the bad, wash your hands, grab a measuring tape and a Pinard stethoscope.
Begin the examination by looking at the overall appearance of the patient. Ask if they are in any pain and are comfortable . Signs such as jaundice and oedema may be clearly visible from the end of the bed.
Assess distal perfusion by recording the capillary refill time. Apply pressure to the distal phalanx of the patient's index finger for five seconds . The finger should turn pale but revert back to its normal colour within less than two seconds . Poor perfusion can be caused by many pathologies including dehydration, aortocaval compression and septic shock.
Look in the eyes for conjunctival pallor (anaemia) and jaundice (intrahepatic cholestasis of pregnancy or hepatitis). Check for oedema of the face (a sign of pre-eclampsia).
It is important to inspect the abdomen for pregnant signs such as:
Observe for any scarring , which may be from previous abdominal surgery or a previous Caesarean section. The most common Caesarean section scar is the Pfannenstiel scar .
If the woman is greater than 24 weeks gestation, foetal movements may be visible.
Ask again if the patient has any pain around their abdomen. Softly palpate the 9 quadrants (see the abdominal examination page) of the pregnant abdomen, feeling for the borders of the uterus. Whilst palpating, look at the patient's face for any signs of discomfort and note down any tenderness or guarding .
The symphysis-fundal height is the length measured between the fundus (the top of the uterus) and the pubic symphysis. This is important as it helps determine if the pregnancy is too large or small for the gestational age .
To measure the symphysis-fundal height, use the ulnar aspect of your left hand, palpate close to the xiphisternum and slowly move inferiorly to locate the fundus. The fundus will feel firm at the uppermost part of the pregnant abdomen. Place one end of the measuring tape face down at this location, and then, palpate for the pubic symphysis and place the other end of the tape there. Measure this distance and repeat two more times.
The foetal lie governs the direction the foetus is facing. Start on the right-hand side of the bed, face the patient and place your hands on either side of the pregnant abdomen. Gently palpate each side. One should be firmer than the other; this will be the foetal back. On the opposite side, you may be able to feel the foetal limbs.
The foetus may lie in one of three ways:
The presentation refers to the anatomical part of the foetus that is closest to the pelvic inlet.
Facing the mother, place your hands on either side of the lower abdomen just above the pubic symphysis. Apply pressure firmly towards the midline to feel the presenting part. If this feels hard, round, and mobile , then it is likely the foetal head. If it feels softer and less well defined , then this is suggestive of another anatomical part such as the bottom.
The presentation can be described in many ways. Three important ones are:
Foetal engagement refers to when the presenting part of the foetus descends into the pelvis. This can be measured as “fifths palpable”. Assuming a cephalic presentation, if the foetal head is not engaged, you will be able to feel the whole foetal head on the abdomen using your hand (five fifths palpable). If you cannot feel the foetal head, then it may have descended into the pelvis (zero fifths palpable). If you can feel the foetal head with only three fingers, it is three fifths palpable. This means that the foetal head is two fifths engaged.
Auscultation of the foetal heart is performed using the Pinard stethoscope, or otherwise a Doppler foetal heart rate monitor. Awareness of the foetal lie and presentation makes it much easier to place the stethoscope. It best to try to place it over the anterior shoulder of the foetus. This is typically found around two inches laterally from the midpoint between the umbilicus and pubic symphysis. Place the wide end of the stethoscope on the patients abdomen and your ear on the flat end. Next, press your ear firmly down and let go of the stethoscope with your hands; it should be balanced between your ear and the patient’s abdomen. Palpate the maternal pulse at the same time to distinguish between the maternal and foetal heart beat.
Thank the patient allow them to re-dress behind the curtains and wash your hands. Complete your examination by offering to measure blood pressure, perform urinalysis, measure weight and height, and accurately assess foetal heart rate using a Doppler ultrasound.
All textual content, images not distributed under a share-alike license and website design ©2020 SimpleOSCE.
https://www.clearblue.com/am-i-pregnant/quiz
https://simpleosce.com/examinations/obstetrics-and-gynaecology/pregnant-abdomen-exam.php
Private Fantasies 1
Natural Mature Porno Hairy
Strapon Teen Hot Seduce Busty Lesbian
Am I Pregnant? Quiz - Clearblue®
Pregnant abdomen examination station - OSCE
Am I Pregnant Quiz: Symptoms Test - Clearblue
Online Pregnancy Test with 91% Accuracy - Am I Pregnant Quiz
Am I Pregnant Quiz | Early Signs of Pregnancy
Am I Pregnant? Quiz | Pampers
A Quiz to Help Determine if You're Pregnant
Free Online Pregnancy Test - Am I Pregnant? Quiz
Am I Pregnant Quiz? Online Pregnancy Test [FREE]
Pregnant Exam
