Post on 30-May-2018
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eopold s Manaeuvereopold s Manaeuver. ,EFFREY A LUCERO . .L
III Bachelor of Science in Nursing, ,Cavite State University Indang Cavite
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ContentsContents
DefinitionPreparatory ProceduresManaeuvers
First ManaeuverSecond ManaeuverThird Manaeuver
Fourth Manauver
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DefinitionDefinition
a common and systematic way todetermine the position of a fetus insidethe woman's uterus
named after the gynecologist ChristianGerhard Leopold
also used to estimate term fetal weight
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reparatoryreparatoryProceduresrocedures
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1. Instruct woman
to empty herbladder first.
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Rationale:
The full bladder
may be mistakenly apart of the fetus.
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2. Place woman in dorsalrecumbent position, supinewith knees flexed to relax
abdominal muscles. Place asmall pillow under the headfor comfort.
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Rationale:
This easily exposes
the body part to beexamined.
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3. Drape the client
properly.
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Rationale:
This promotes
privacy.
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4. Explain procedure tothe patient.
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Rationale: This make the clientknowledgeable and
establishes rapport betweenthe her and the nurse.
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5. Warm hands by rubbingtogether.
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Rationale:
Cold hands can stimulateuterine contractions.
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6. Use the palm forpalpation not the
fingers.
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Rationale:
Doing so clearly verifiesthe accuracy of the
procedure.
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Manaeuversanaeuvers
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First manaeuver:Fundal GripFirst manaeuver:Fundal GripPurpose:1.To determine fetal part lying in the fundus.
2.To determine presentation.
Procedure: Using both hands, feel for the fetal
part lying in the fundus.
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First manaeuver:Fundal GripFirst manaeuver:Fundal Grip
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FindingsFindings
Head is more firm, hard and round that
moves independently of the body.
Breech is less well defined that movesonly in conjunction with the body.
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Second manaeuver:Umbilical GripSecond manaeuver:Umbilical GripPurpose:1.To identify location of fetal back.2.To determine position.
Procedure: One hand is used to steady the uterus on
one side of the abdomen while the otherhand moves slightly on a circular motion
from top to the lower segment of theuterus to feel for the fetal back and smallfetal parts. Use gentle but deep pressure.
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Second manaeuver:Umbilical GripSecond manaeuver:Umbilical Grip
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Third manaeuver:Pawliks GripThird manaeuver:Pawliks GripPurpose:1.To determine engagement of presenting part.
Procedure: Using thumb and finger, grasp thelower portion of the abdomen abovesymphisis pubis, press in slightly andmake gentle movements from side toside.
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Third manaeuver:Pawliks GripThird manaeuver:Pawliks Grip
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FindingsFindings
The presenting part is not engaged if it isnot movable.
It is not yet engaged if it is still movable.
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Fourth manaeuver:Pelvic GripFourth manaeuver:Pelvic GripPurpose:1.To determine the degree of flexion of fetal
head.
2.To determine attitude or habitus. Procedure:
Facing foot part of the woman, palpatefetal head pressing downward about 2
inches above the inguinal ligament.Use both hands.
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Fourth manaeuver:Pelvic GripFourth manaeuver:Pelvic Grip
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FindingsFindings
Good attitude if brow correspond to theside (2nd manaeuver) that contained theelbows and knees.
Poor atitude if examining fingers will meet
an obstruction on the same side as fetalback (hyperextended head) Also palpatesinfants anteroposterior position. If brow isvery easily palpated, fetus is at posteriorposition (occiput pointing towards womans
back)
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some questions?some questions?
That s all for ..Leopold s Manaeuver