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NCM 107 & 105 RLE > Internal Vaginal Examination > Flashcards

Internal Vaginal Examination Flashcards

1
Q

what are the limitations for IVE for nurses?

A

only done during labor

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2
Q

what are the limitations for IVE for midwives?

A

only done during labor

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3
Q

what are the limitations for IVE for doctors?

A

all phases kahit hindi pregnant pa yan

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4
Q

because of RA 9392, nurses are allowed to do what procedure?

A

perform NSD

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5
Q

IVE is done to who?

A

laboring mother

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6
Q

IVE is done to assess what?

A
  • amniotic fluid
  • consistency of the cervix
  • effacement
  • dilatation
  • presentation
  • station
  • pelvic measurements
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7
Q

give the 5 purposes of IVE

A

-consistency of cervix
-length and dilatation
-fetal presenting part
-bony architecture of cervix
-anomalies of the vagina and the perineum
= rectocele, cystocele and lesions

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8
Q

differentiate effacement to dilatation

A

Effacement
- thinning of the cervix

Dilatation
- cervical opening

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9
Q

describe dilatation of the 3 stages of labor

A 
Latent = 0-3 cm
Active= 4- 7 cm
Transition= 8 -10 cm
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10
Q

Give the 5 things to assess before doing IVE

A
  • fullness of the bladder
  • ability to cooperate
  • rupture of membranes
  • uterine contractions
  • vaginal bleeding and cord prolapse
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11
Q

what would be the ideal quality of the bladder during IVE?

A

empty bladder dapat

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12
Q

how are you going to assess patient’s ability to cooperate?

A

tell them that its an Invasive procedure that needs consent and cooperation

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13
Q

what happens when there is any rupture of membranes

A

-IE is no longer probable kapag nagrupture na yung membrane= immediate delivery na dapat

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14
Q

in terms of uterine contractions, when is the best time to do IE?

A
  • uterine contraction is in relaxation
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15
Q

what is the indication if there is vaginal bleeding?

A

○Bleeding abnormalities
■Placenta previa (low lying)
■Abruptio placenta ( premature separation)

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16
Q

what is cord prolapse

A

Mayroon na umbilical cord na lumalabas sa vagina

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17
Q

what does cord prolapse lead to?

A

○ fetal asphyxia (respiratory distress)

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18
Q

give 2 main nursing responsibilities when there is cord prolapse

A
  • position in Trendelenberg position

- Provide wet gauze with sterile saline

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19
Q

why do you do Trendelenberg position if there is cord prolapse?

A

para magretract sa birth canal ung fetus

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20
Q

why do you Provide wet gauze with sterile saline if there is cord prolapse?

A

=support the cord

=prevents damage and distress for baby (place in presenting cord)

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21
Q

give 4 equipments for IVE

A

■stop procedure
■don’t push inside
■No longer NSD
■Report to the doctor

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22
Q

give the first 7 steps in doing IVE

A
  1. identify patient and explain procedure
  2. empty bladder
  3. good lighting
  4. lithotomy position
  5. hand hygiene and wear sterile gloves
  6. KY jelly on the sterile gloves and take a deep breath.
  7. middle and index finger towards the posterior vaginal wall.
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23
Q

give the 8-14 steps in doing IVE

A
  1. consistency
  2. effacement
  3. dilatation
  4. membranes of bag of water
  5. degree of descent
  6. presentation
  7. position
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24
Q

what is the consistency of the cervix during labor

A

butter soft

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25
if the length of the cervix is @ 2.5 cm what does it indicate?
not yet effaced (0% effaced)
26
if the length of the cervix is @ 0.5 cm what does it indicate and its consistency?
nut-like (95% effaced)
27
if the cervix is paper thin what does it indicate?
Fully effaced
28
what comes first in the effacement of a primigravid?
effacement muna bago dilatation | ➜mauuna ang pagnipis bago bumuka
29
what comes first in the effacement of a multipara patient?
➜sabay yung effacement and dilatation | ➜mas mabilis ang panganganak
30
Give the normal Findings for dilatation Individually
Index finger ➜ 1 cm | Middle finger ➜ 1.5 cm
31
what is the measurement of dilatation kapag Nakapasok magisa index finger ?
1cm dilatation
32
what is the measurement of dilatation kapag middle and index ang nakapasok?
1.5 cm / 2cm dilatation
33
what is the measurement of dilatation if Middle & index mabubuka ng sobra sa cervix?
fully dilated (10 cm)
34
during a contraction what happens to the membranes or bag of water?
they tend to bulge and are intact
35
what is the interval for IE?
4 hours
36
why is the interval for IE only 4 hours? Give 3 reasons
-Cervix namamaga= obstruction -Prevent inflammation, trauma, injury of the cervix -Dilates 1cm every hour during the active labor stage Kunyari, done ka na with first IE during active stage tas nakuhang result 4 cm. After 4 hours nag-IE ka ulit, dapat 8cm na kasi nga [ dilates 1cm/hour]
37
Degree of descent ➜
station
38
ischial spine
(landmark)
39
Give the purpose of the middle and index finger in locating the ischial spine and determining the degree of descent of the presenting part
middle finger= ischial spine | index finger= kakapkap sa ulo
40
what is the formation of the fingers if the presenting part is at 0 station?
pantay yung middle and index
41
what is the formation of the fingers if the presenting part is at negative station
naka angat yung index finger
42
what is the formation of the fingers if the presenting part is at positive station?
naka baba ung index finger
43
what does it mean if the presenting part is at negative station?
above the ischial spine
44
what does it mean if the presenting part is at positive station?
below the ischial spine
45
what does it mean if the presenting part is floating?
- presenting part not yet entered maternal true pelvis - above the ischial spine - movable
46
what station is the presenting part in if its floating?
-3 to -4 station
47
what does it mean if the presenting part is engaged?
- presenting part has entered true maternal pelvis | - no longer movable
48
what station is the presenting part in if its engaged?
-1 to -2 station | +1 to +2 station
49
what does it mean if the presenting part is at 0 station?
presenting part is at the level of the ischial spine
50
what does it mean if the presenting part is crowning?
fetal head/ presenting part is visible and is ready to come out
51
what station is the presenting part in if its crowning?
+3 to +4 station
52
what does it mean when we say "the presenting part is at -1 station?"
1 cm above ischial spine
53
what does it mean when we say "the presenting part is at +3 station"?
3 cm below ischial spine
54
give the 4 types of the quality of the cephalic presentation
a) Occiput or vertex ➜ fully flexed b) Cinciput or straight ➜ military position c) Brow ➜ brow d) Face ➜ face
55
what is the most favorable cephallic position for NSD?
Occiput or vertex
56
why is Occiput or vertex Most favorable cephallic position for NSD?
- Very short suboccipitobregmatic diameter - the diameter of the fetal head is 9.5 cm which is very small meaning it can easily pass through the gynecoid pelvis of the mother
57
what are the 2 types of position in cephalic presentation?
Occiput anterior | Occiput posterior
58
describe occiput anterior
- fontanels faces away from the maternal spine | - magkabaliktaran ang fetus at mother
59
describe occiput posterior
- magkadikit ung spine ni mother and fetus | - back to back ung spine ni mother and fetus
60
what is the most favorable type of position in cephalic presentation?
Right or left occiput anterior
61
describe Right or left occiput anterior
Magkabaliktaran si mother and fetus | Fontanels faces away from maternal spine
62
what are the 4 things you're going to evaluate?
- response after - progress of labor - significant and unusual findings. - result
63
why is less IE is done once membranes have ruptured?
baby needs to be delivered already

NCM 107 & 105 RLE (1 decks)

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