skills OB

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  1. how to check fundus:

    what are you palpating the fundus for?
  2. how to check the fundus:

    what is a normal fundus assessment?
    • 1. firm
    • 2. grapefruit size
    • 3. midline, below the umbilicus
  3. how to check an episiotomy:

    what position do you place the mother in to assess an episiotomy and why?
    1.the SIMS position

    2. with a gloved hand i will gently raise the upper buttocks just enough to see the episiotomy bc the mother might have ripped to the rectal area
  4. what Pt teachings will be recommended for mothers to decrease episiotomy discomfort?
    • 1. redness - inflammation
    • 2. ecchymosis - bruising
    • 3. edema - swelling
    • 4. discharge - from incision
    • 5. approximation of suture line
  5. post partum assessment:

    why may bladder distention occur post delivery?
    after delivery the bladder, urethra, and tissue around the urinary meatus gets swollen and traumatized leading to dysuria. Mother may also have residual urine.
  6. what are the 2 most common urinary complications post delivery?
    UTI (urinary tract infection) and stasis (state of inactivity)
  7. what is the tell-tale sign of bladder distention or urinary stasis?
    uterus will be up and to the side - primary cause of excessive bleeding
  8. whats the difference between a straight cath and indwelling cath?
    1. straight cath - intermittent use - not left in place

    2. indwelling - usually long term, and left in place
  9. why is a leopolds manuever done?
    series of palpations to assess fetal position
  10. what position is the mother place in during a leopolds manuever
    supine with knees bent
  11. breech = ?
  12. what is the first thing the examiner will do for leopolds manuever. (generally breech)
    palpate to determine which fetal part is in the fundus
  13. fundus = ?
    top of uterus
  14. what is the 2nd step in leopolds manuever
    move hands to sides of uterus to determine which side the fetal back is located
  15. what is the third step in leopolds manuever
    right hand is placed above the symphysis pubis to check for head or breech
  16. what is the 4th leopolds manuever
    turn around and face clients feet and palpate abdomen sides to determine which side the cephalic prominence presents and to see if the baby's cephalic dropped into the pelvis yet
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skills OB
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