8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

1/18

CARING FOR THE PREGNANTCLIENT

ASSESSMENT

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

2/18

Health History (Biographical Information

Name(family name, first then middle name) Address(permanent and official), phone number and persons t

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

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

3/18

Family Profile/Family History

Ask about marital status Know size of apartment or home (ie: need to climb stairs, room f

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 experience

by the pregnant womans mother

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

4/18

Past Medical History

Diseases that can pose difficulty during pregnancy include kidnedisease, heart disease, HPN,STI (Hep .HIV)DM, thyroid disease,gallbladder disease, UTI,PKU,TB,asthma.

Childhood diseases-mumps,chickenpox(varicella),mumps(parotitis),measles(rubeola), germameasles(rubella),poliomyelitis.

Allergies and drug sensitivities including food allergy Past surgeries

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

5/18

Social Profile

1. Nutrition 2. Exercise 3. Hobbies 4. Smoking

5. Recreational drugs 6. Alcohol intake 7. Partner abuse 8. Medication history

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

6/18

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

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

7/18

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

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

8/18

DETERMINING EDC

NAEGELES RULE A method used to determine or calculate the date of birth

of the infant or expected date of confinement (EDC) forthe delivery of the mother.

A standard method used to predict the length of thepregnancy.

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

9/18

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

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

10/18

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

11/18

LEOPOLDS MANEUVER Physical Assessment

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

12/18

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 rel

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 contractio Use the palm for palpation not the fingers

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

13/18

Purpose

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

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

14/18

First Maneuver:To determine fetal part lying in the fundus.

To determine presentation.procedure: Using both hands, feel for thefetal part lying in the fundus.

Head is more firm, hard and round, and ismore mobile and ballottable.

Breech feels as a large, nodular mass.

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

15/18

Second Maneuver: To identify location of fetal back.

To determine position.

Procedure : One hand is used to steady theuterus on one side of the abdomen whilethe other hand moves slightly on acircular motion from top to the lowersegment of the uterus to feel for the fetal

back and small fetal parts.Use gentle but deep pressure.

Fetal back is smooth, hard, and resistantsurfaceKnees and elbows of fetus feels with anumber of small, irregular, mobile parts

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

16/18

Third Maneuver: To determine engagement of

presenting part.

procedure: Using thumb and finger,grasp the lower portion of theabdomen above symphisis pubis, pressin slightly and make gentlemovements from side to side.

The presenting part is engaged if it isnot movable.

It is not yet engaged if it is stillmovable

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

17/18

Fourth Maneuver: To determine if the presentation has

descended into the pelvis To determine the position of the fetal

presentationprocedure: Facing foot part of the woman,

using the tips of the first three fingers,exerts deep pressure in the direction ofthe axis of the pelvic inletUse both hands.

8/14/2019 CARING FOR THE PREGNANT CLIENT.pptx

18/18

Fundal Height