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    Caring For The Pregnant Client

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    tammy_1025043737
    This document provides guidance on assessing a pregnant client, including collecting: 1) Health, family, social, gynecological, and obstetric histories; 2) Performing a physical assessment using Leopold's maneuvers to determine fetal position, presentation, and engagement; 3) Measuring fundal height to estimate age of gestation. The assessment establishes a health baseline and identifies risks to provide prenatal care, education, and monitoring of the pregnancy.

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    Caring For The Pregnant Client

    Uploaded by

    tammy_1025043737
    106 views18 pages
    This document provides guidance on assessing a pregnant client, including collecting: 1) Health, family, social, gynecological, and obstetric histories; 2) Performing a physical assessment using Leopold's maneuvers to determine fetal position, presentation, and engagement; 3) Measuring fundal height to estimate age of gestation. The assessment establishes a health baseline and identifies risks to provide prenatal care, education, and monitoring of the pregnancy.

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    assessment, diagnostic studies, and interventions

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    CARING FOR THE PREGNANT CLIENT.pptx

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    This document provides guidance on assessing a pregnant client, including collecting: 1) Health, family, social, gynecological, and obstetric histories; 2) Performing a physical assessment using Leopold's maneuvers to determine fetal position, presentation, and engagement; 3) Measuring fundal height to estimate age of gestation. The assessment establishes a health baseline and identifies risks to provide prenatal care, education, and monitoring of the pregnancy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    106 views18 pages

    Caring For The Pregnant Client

    Uploaded by

    tammy_1025043737
    This document provides guidance on assessing a pregnant client, including collecting: 1) Health, family, social, gynecological, and obstetric histories; 2) Performing a physical assessment using Leopold's maneuvers to determine fetal position, presentation, and engagement; 3) Measuring fundal height to estimate age of gestation. The assessment establishes a health baseline and identifies risks to provide prenatal care, education, and monitoring of the pregnancy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 18

    CARING FOR THE PREGNANT CLIENT

    ASSESSMENT

    Health History (Biographical Information)


    Name(family name, first then middle name) Address(permanent and official), phone number and persons to be contacted in case of emergency Birth date, age, sex, ethnic origin/race Place of birth Marital status Religion Occupation(usual and present) Educational status

    Family Profile/Family History


    Ask about marital status Know size of apartment or home (ie: need to climb stairs, room for baby etc) Know her age and sexual partners age Educational level Occupation Communicable diseases suffered by other members of the family whom the pregnant woman lives with(ie: measles, TB etc) Pregnancy and delivery difficulties and complications experienced by the pregnant womans mother

    Past Medical History


    Diseases that can pose difficulty during pregnancy include kidney disease, heart disease, HPN,STI (Hep .HIV)DM, thyroid disease, gallbladder disease, UTI,PKU,TB,asthma. Childhood diseases-mumps, chickenpox(varicella),mumps(parotitis),measles(rubeola), german measles(rubella),poliomyelitis. Allergies and drug sensitivities including food allergy Past surgeries

    Social Profile
    1. Nutrition 2. Exercise 3. Hobbies 4. Smoking 5. Recreational drugs 6. Alcohol intake 7. Partner abuse 8. Medication history

    Gynecologic History
    Menarche age and how well she was prepared for it Menstrual cycle interval,duration,amount of low, any discomfort-how long,degree,when it occurs relief Monthly perineum self examination BSE Past surgery on the reproductive tract tubal surgery Reproductive planning method IUD, Oral pill Sexual history Assess for possibility of stress incontinence

    Obstetric History
    Past pregnancies Previous miscarriages or abortions and complications OB Scoring Gravida Para/Parity 2 Methods of Scoring: 1. Gravida-Para (GP) 2. GP TPAL Method or GP TPALM

    DETERMINING EDC
    NAEGELES RULE A method used to determine or calculate the date of birth of the infant or expected date of confinement (EDC) for the delivery of the mother. A standard method used to predict the length of the pregnancy.

    DETERMINING AOG
    AOG in weeks= Fundal Height (FU in cm)x 8/7 DURATION OF PREGNANCY IN LUNAR MONTHS= Fundic height (FU in cm) x 2/7 LMP known by mother

    PRENATAL CARE
    Purpose of prenatal: Risk for Complications pregnant mothers must be identified Establish a baseline of present health Monitor fetal development Age of Gestation Time for education about pregnancy, lactation and newborn care Anticipating and preventing problems before they occur to minimize risk of possible complications Low birth weight babies reduced

    Physical Assessment

    LEOPOLDS MANEUVER

    Leopold maneuver
    Leopold maneuver is established by Leopold in1848 Preparations before examination
    Instruct woman to empty her bladder first. Place woman in dorsal recumbent position, supine with knees flexed to relax abdominal muscles. Place a small pillow under the head for comfort. Drape properly to maintain privacy Explain procedure to the patient. Warms hands by rubbing together. (Cold hands can stimulate uterine contractions). Use the palm for palpation not the fingers

    Purpose
    to assess position of baby determine fetal heart rate to know if the head is already engaged

    First Maneuver:
    To determine fetal part lying in the fundus. To determine presentation. procedure: Using both hands, feel for the fetal part lying in the fundus. Head is more firm, hard and round, and is more mobile and ballottable. Breech feels as a large, nodular mass.

    Second Maneuver:
    To identify location of fetal back. To determine position. Procedure: One hand is used to steady the uterus on one side of the abdomen while the other hand moves slightly on a circular motion from top to the lower segment of the uterus to feel for the fetal back and small fetal parts. Use gentle but deep pressure. Fetal back is smooth, hard, and resistant surface Knees and elbows of fetus feels with a number of small, irregular, mobile parts

    Third Maneuver:
    To determine engagement of presenting part. procedure: Using thumb and finger, grasp the lower portion of the abdomen above symphisis pubis, press in slightly and make gentle movements from side to side. The presenting part is engaged if it is not movable. It is not yet engaged if it is still movable

    Fourth Maneuver:
    To determine if the presentation has descended into the pelvis To determine the position of the fetal presentation procedure: Facing foot part of the woman, using the tips of the first three fingers, exerts deep pressure in the direction of the axis of the pelvic inlet Use both hands.

    Fundal Height

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