Page 197 - ترم ثاني كتاب تمريض صحة الام الكتروني

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• Test urine for protein and sugar after trimming of hair, and before enema.
3-Local examination:

▪ Examination of the abdomen:
✓ Inspect the contour of the abdomen.
✓ Palpate the abdomen gently, and with warm hands, for the height of the

fundus, lie, presentation, position, attitude and station, and record them.
✓ Observe and record the frequency, duration, and intensity of contractions.
✓ Auscultate and record the fetal heart sound for one minute using Pinard's
stethoscope, or Sonicaid. A cardiograph machine gives information about fetal

and maternal conditions. The normal range of the fetal heart rate is 120- 160
beats/minute.
▪ Examinationof the vulva:

✓ Inspect for gaping of introitus.
✓ Observe color and odor of liquor amnio, and presence of meconium or
blood. Offensive odor indicates infection.

✓ Check for edema of the vulva. If present, it indicates pre-eclampsia.
▪ Examination of the vagina:
Is made by doctor to:

✓ Make a positive diagnosis of labor.
✓ Assess the progress of labor.
✓ Determine the extent of effacement and the degree of dilatation of the

cervix.
✓ Assess the condition of the membranes.
✓ Determine position, presentation and degree of descent of head in pelvis

in relation to ischial spine (station).
✓ Observe the presence of umbilical cord beside the head.
✓ Check molding, presence of caput succedaneum, and abnormalities.
✓ Evaluate pelvic capacity and condition of the vagina.

▪ Examination of the rectum:
A rectal examination is safer than a vaginal examination. It reduces the risk of
infection and gives the same data as a vaginal examination.

➢ The Partograph:
The partograph is a single page graphic chart designed to record all the important

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