Perform a focused physical examination on a pregnant woman with abdominal pain
Learner Task: Perform a focused physical examination on a pregnant woman with abdominal pain.
Educator Script: Provide the following details of focused physical examination as asked by the learner:
- Vital Signs: BP 124/84, P 101, Resp 22, afebrile, EFW 3200 grams
- General: awake, alert and oriented x3 in moderate distress with contractions
- Heart: Nl S1 S2, RRR, no murmurs, rubs or gallops
- Lungs: bilaterally CTA, no wheezes, rales, or rhonchi
- Abdomen: +BS, gravid, fundal height 36, non-tender to palpation, no guarding, no rebound
- Speculum: no blood, +pooling, +nitrazine
- Pelvic: vulva/vagina: normal external genitalia
- Cervix: 4/50/0/vertex, wet mount performed
- Extremities: no clubbing, cyanosis, or edema
- Microscopic examination of vaginal fluid shows:
Educator Checklist: Physical Examination
Mark the appropriate column to indicate whether the learner included each element in his or her response. When completed, tally the “Included” column to calculate the learner’s score.
| Included =1 | Not Included =0 | |
| Abdominal exam: fundal height and tenderness between UCs | ||
| Leopold/fetal lie | ||
| Performs speculum exam and collects specimen | ||
| Performs intrapartum examination | ||
| Identifies positive nitrazine and ferning |
Educator Checklist: Intrapartum Examination
Mark the appropriate column to indicate whether the learner included each element in his or her response. When completed, tally the “Included” column to calculate the learner’s score.
| Included =1 | Not Included =0 | |
| Describes the benefits, risks and indications for cervical assessment | ||
| Describes the technique of properly assessing dilation, effacement and station | ||
| Explains procedure to patient | ||
| Puts on gloves in a sterile fashion | ||
| Uses lubricant on two fingers that will be used to perform vaginal examination | ||
| Uses non-dominant hand to separate labia | ||
| Uses two fingers of the dominant hand to assess the cervix | ||
| Assesses presenting part | ||
| Accurately assesses cervical dilation | ||
| Accurately assesses cervical effacement | ||
| Demonstrates appropriate sterile technique throughout examination |