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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
Q

if the length of the cervix is @ 2.5 cm what does it indicate?

A

not yet effaced (0% effaced)

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26
Q

if the length of the cervix is @ 0.5 cm what does it indicate and its consistency?

A

nut-like (95% effaced)

27
Q

if the cervix is paper thin what does it indicate?

A

Fully effaced

28
Q

what comes first in the effacement of a primigravid?

A

effacement muna bago dilatation

➜mauuna ang pagnipis bago bumuka

29
Q

what comes first in the effacement of a multipara patient?

A

➜sabay yung effacement and dilatation

➜mas mabilis ang panganganak

30
Q

Give the normal Findings for dilatation Individually

A

Index finger ➜ 1 cm

Middle finger ➜ 1.5 cm

31
Q

what is the measurement of dilatation kapag Nakapasok magisa index finger ?

A

1cm dilatation

32
Q

what is the measurement of dilatation kapag middle and index ang nakapasok?

A

1.5 cm / 2cm dilatation

33
Q

what is the measurement of dilatation if Middle & index mabubuka ng sobra sa cervix?

A

fully dilated (10 cm)

34
Q

during a contraction what happens to the membranes or bag of water?

A

they tend to bulge and are intact

35
Q

what is the interval for IE?

A

4 hours

36
Q

why is the interval for IE only 4 hours? Give 3 reasons

A

-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
Q

Degree of descent ➜

A

station

38
Q

ischial spine

A

(landmark)

39
Q

Give the purpose of the middle and index finger in locating the ischial spine and determining the degree of descent of the presenting part

A

middle finger= ischial spine

index finger= kakapkap sa ulo

40
Q

what is the formation of the fingers if the presenting part is at 0 station?

A

pantay yung middle and index

41
Q

what is the formation of the fingers if the presenting part is at negative station

A

naka angat yung index finger

42
Q

what is the formation of the fingers if the presenting part is at positive station?

A

naka baba ung index finger

43
Q

what does it mean if the presenting part is at negative station?

A

above the ischial spine

44
Q

what does it mean if the presenting part is at positive station?

A

below the ischial spine

45
Q

what does it mean if the presenting part is floating?

A
  • presenting part not yet entered maternal true pelvis
  • above the ischial spine
  • movable
46
Q

what station is the presenting part in if its floating?

A

-3 to -4 station

47
Q

what does it mean if the presenting part is engaged?

A
  • presenting part has entered true maternal pelvis

- no longer movable

48
Q

what station is the presenting part in if its engaged?

A

-1 to -2 station

+1 to +2 station

49
Q

what does it mean if the presenting part is at 0 station?

A

presenting part is at the level of the ischial spine

50
Q

what does it mean if the presenting part is crowning?

A

fetal head/ presenting part is visible and is ready to come out

51
Q

what station is the presenting part in if its crowning?

A

+3 to +4 station

52
Q

what does it mean when we say “the presenting part is at -1 station?”

A

1 cm above ischial spine

53
Q

what does it mean when we say “the presenting part is at +3 station”?

A

3 cm below ischial spine

54
Q

give the 4 types of the quality of the cephalic presentation

A

a) Occiput or vertex ➜ fully flexed
b) Cinciput or straight ➜ military position
c) Brow ➜ brow
d) Face ➜ face

55
Q

what is the most favorable cephallic position for NSD?

A

Occiput or vertex

56
Q

why is Occiput or vertex Most favorable cephallic position for NSD?

A
  • 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
Q

what are the 2 types of position in cephalic presentation?

A

Occiput anterior

Occiput posterior

58
Q

describe occiput anterior

A
  • fontanels faces away from the maternal spine

- magkabaliktaran ang fetus at mother

59
Q

describe occiput posterior

A
  • magkadikit ung spine ni mother and fetus

- back to back ung spine ni mother and fetus

60
Q

what is the most favorable type of position in cephalic presentation?

A

Right or left occiput anterior

61
Q

describe Right or left occiput anterior

A

Magkabaliktaran si mother and fetus

Fontanels faces away from maternal spine

62
Q

what are the 4 things you’re going to evaluate?

A
  • response after
  • progress of labor
  • significant and unusual findings.
  • result
63
Q

why is less IE is done once membranes have ruptured?

A

baby needs to be delivered already

NCM 107 & 105 RLE (1 decks)

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