Title NCM 113 MIDTERMS- RLE ✅

NCM 113 MIDTERMS RLE BY TONS AND MADS 1. Fundal grip - facing woman, palpate the woman's upper abdomen with both hands. 2. Umbilical grip - determining of location of fetal back; palpating Both sides of the maternal abdomen. The fetal back will feel firm and smooth. 3. Pawlick’s Grip - grasp lower portion of abdomen just above pubis synthesis with thumb and fingers. This maneuver should yield the opposite information and validate the findings of first maneuver To confirm your findings Of the presenting part. 4. Pelvic Grip - to determine fetal head extension or flexed; to determine where your baby's brow is located EQUIPMENT NEEDED: Doppler, Stethoscope, Tape measure, lubricator, tissue paper PROCEDURE 1. Wash hands before performing to remove microorganism that lodge in the hands. 2. the examiner hand should be warm to prevent tensing of the abdominal muscle 3. Identify self to the client to provide patients comfort 4. explain procedure to the patient to reduce anxiety and ensure cooperation. 5. woman empties her abdomen before examination so that the mother will not be able to feel uncomfortable during the palpation 6. provide privacy to prevent from getting embarrassed 7. client position should be in dorsal recumbent with one pillow under the head. This help relax the abdominal muscles to enhance palpation 8. Examiner stands basing the woman on the right side if he or she right-handed and vice versa if he is left-handed. This is for easy access of doing the procedure. 9. Do the First Maneuver FUNDAL GRIP a.Facing tmother, palpate the sites of the uterus and fundus by using both palms. b.palpate t superior surface of fundus and determines the consistency, shape, and mobility of palpated part. c.Determine if fetal head or bridge is on fundus, the fetal head is firm, hard, and round, and moves independently d.Breech feels smooth 10. Second Maneuver UMBILICAL GRIP a.Still facing mother, examiner’s palmar surface of the hands will be placed on the sides of the abdomen. To identify the location of the back and small parts. b.Palpate down sides of the uterus apply gentle but firm deep pressure in the side of fetal back, it is a long continuous structure, smooth and firm will be felt the side & it is important to know the location of the fetal back which can guide you to locate an audible fetal heart sound of the fetus c.the fetal extremities will feel nodular reflecting on the portion of fetal extremities 11. 3rd Maneuver PAWLIKS GRIP a.Still facing mother, grasping lower uterine segment between thumb and fingers of one hand to feel the presenting part b.The examiner place one hand just above symphysis whether palpated part feels like fetal head or the breech and whether the presenting part is engaged c.Moving = not engaged, Not moving = engaged 12. 4th Maneuver PELVIC GRIP a.Turning and facing woman’s feet, gently moving the fingers down the sides of the uterus. b.2 inches above inguinal ligaments and presses downward and inward in the direction of the birth canal FETAL HEART TONE TAKING 1.Note location, rate and character 2.Determine position, presentation of fetus by palpation. 3.Place stethoscope on abdomen over the back or chest of t fetus, depending which is closer to the uterine exit. 4.Listen and count the beat for 1 minute. Avoid friction noises caused by fingers on abdominal area. 5.Check rate before, during and after the contraction. Differentiate between FHT and other abdominal sounds. a.Fetal Heart Tones – very rapid, somewhat muffled tickling sound. b.Uterine bruit - soft murmur caused by passage of blood through dilated uterine vessels, synchronous with maternal pulse. c.Funic Souffle – hissing sound produced by passage of blood through umbilical arteries, synchronous with FHR Demonstration of Leopold’s 18:40 - 30:08 1. Wash hands before the procedure. 2. Identify self to the client. 3. Explain the procedure to the client. 4. The pregnant client empties her bladder. 5. Provide privacy. 6. the client is positioned in dorsal recumbent with one pillow under the head. 7. Stand facing the client on the right if right-handed (viceversa if left-handed.) 8. Observe client’s abdomen for longest diameter and where fetal movement is apparent. 9. Measure the fundic height of client’s abdomen. 10. Warm hands before the procedure. 11. Facing the client, place both hands flat on the superior surface of the fundus. Palpate the client’s fundus using the fingertips. 12. Still facing the client, place the palmar surface of each of hand on either side of the client’s abdomen. Palpate the sides of the uterus by holding the left hand stationary on the left of the uterus, while the right hand palpates the opposite side of the uterus from top to bottom. Repeats palpation on the other side using the other hand. 13. Still facing the client, gently grasps the lower portion of the abdomen just above the symphysis pubis between the thumb and index finger. 14. Turn and face the client’s feet. Place fingers on both sides of the uterus approximately 2 inches above the inguinal ligaments and press downwards and inwards in the direction of the birth canal. 15. place the stethoscope on the client’s abdomen over the back or chest of the fetus. 16. Differentiate between the fetal heartbeat and other abdominal sounds (uterine bruit and funic suffle). Listen and count the fetal heartbeat for 1 minute. Note rate and character of fetal heart tone. 17. Explain to the client the findings of the palpation and auscultation 4