INSTITUDE OF NURSING EDUCATION

J.J.HOSPITAL MUMBAI

CLINICAL PRACTICE TEACHING

ON
ANTENATAL EXAMINATION

SUBMITTED TO-

Dr. Aparna madam

HOD obstetrics and gynecology

SUBMITTED BY:

Ms. Vidya p. Bhakare

F.Y. Msc. Nursing

Batch- 2018-2020
Name of Student Teacher- - Ms. Vidya Pratap Bhakare
Subject -Maternal Nursing
Unit -Unit 3 Normal pregnancy
Topic -Antenatal examination
Method of Teaching -Demonstration
Class -1st year P B BSC Nursing
Date
Time- 30 min
Venue - Antenatal ward JJ hospital.
A V Aids - Activity aid, Article, patient

Previous knowledge –Group has previous knowledge about normal

physiological changes in pregnancy
OBJECTIVES
General objectivesStudent –Teacher centered general objectives
The student teacher will able to

1) Prepare lesson plan on ANC Examination by using elements of lesson plan.

2) Prepare & use of A V aids by using principles of A V aids

3) Conduct clinical teaching on ANC Examination by using teaching learning

process& scientific principle.

4) Evaluate self & student clinical teaching.

Student CenteredGeneral Objectives

The student will able to

1) Revise knowledge about areas of ANC Examination.

2) Prepare ANC examination tray.

3) Conduct antenatal examination.

4) Do proper & accurate recording
Sr Specific Time Content Teaching Learning AV Evaluation
no objective activity activity Aids
1 Introduction 2min By verbal Students
communicatio will listen
The ANC supervision should be a regular & n the carefully
periodic nature in accordance with the principles introduction
laid down or more frequently according to the need will tell
of the individual. The care should start from the
beginning of the pregnancy &end at delivery

2 Student will 2min Systematic supervision (Examination & advice) By asking Student will ANC Student
able to tell during pregnancy is called antenatal care question what responds Mother tells
definition is mean by definition
of antenatal antenatal care?
care

Definition will Student will

explain write
definition
3 Student will 2min Top sheet - To cover the mother All required Students Live Student
 able to articles will will tell the articles prepares
prepare Spigmomanometer –to record the BP show to the uses of each ANC
ANC students ask article examinatio
examination Measuring tape & scale - To measure abdominal the uses of n tray
tray girth ,fundal height & height of the mother each

Students
Weighing machine - To take weight of the mother The uses of will
article explain observes
to the students carefully
Fetoscope /stethoscope - To auscultate fetal heart
sound

Cotton swab - To clean the secretion

Paper bag - To collect the soil cotton swab

4 Students 2min Explain procedure to the patient- to gain cooperation By Students ANC Student
will able to demonstration will listen Mother does
do Ask patient to empty her bladder- Full bladder will the preparation carefully preparation
preparation increases the height of the uterus of patient will
of patient explain
 Mother should be placed dorsal position with legs
slightly flexed – it will make the abdominal muscles
relax
Abdomen should be fully exposed

Collect required article at bedside & stand on the

right of the bed - convenient for examination

Before doing palpation rub your hands properly &

make it warm - Cold touch will cause contraction

5 Student will 2min Build –obese /average/thin By asking Student will Demons Student
able to do Nutrition –good / average /poor question how respond tration does
general Height – 4 feet 7 inches short stature associates do you do of general
examination with small pelvis general Student will general examinatio
examination? observes examina n
Weight –to rule out fetal well-being as well as more carefully tion
than 2kg weight gain per month is sign of pre
eclampcia. By live
demonstration
Tongue teeth & gum – glossitis & stomatitis general
indicates malnutrition & can lead to auto geneous examination
infection in puerperium will explain
 Oedema –physiological edema will occur in last
trimester due to weight gain & pathological pitting
edema will occur due to PIH .

Neck-neck veins ,thyroid gland are looked for

abnormality -physiological enlargement occur
during pregnancy
6 Student will 2min Pallor sites to be noted are lower palpebral By live Student will Live Student
able to do conjunctiva ,dorsum surface of the tongue , & nail demonstration understands demonst does
demonstrati bed -Faint color of the conjunctiva ,dorsum surface of pallor examination ration examinatio
ons of of the tongue& poor capillary refill of nail bed examination of pallor n of pallor.
examination indicates anemia will explain
of pallor

7 Student will 2min Physiological –due to weight gain By live Student will Live Student
able to Pre-eclampcia demonstration ask demonst does
understands Anemia & hypoprotinemia assessment of question ration assessment
causes of Cardiac failure edema & about of edema
edema in Nephrotic syndrome
pregnancy Petting edema is pathological –if pressure given on pitting edema pitting
ankle or any bony prominences for 5 sec & release will explain edema
the depression will for some time is called pitting assessment
edema . of edema
8 Student will 2min Breast examination in pregnancy is done to note the Question will Student will Live Student
able to nipples (cracked or depressed) & skin condition of ask why responds demonst does breast
perform the areola -To correct the abnormality if any so that breast ration examinatio
breast there will be no difficulty in breast feeding examination is n in ANC
examination immediately following delivery important in mother
inpregnancy ANC mother
Skin changes –look for venous congestion
Demonstration Students
In areola –secondary areola ,Montgomery tubercle of breast will observe
examination carefully
Any sign of infection will show.

9 Student will 2min Look for Skin changes –lenia nigra, striae gravid By live Student will Live Student
able to do arum demonstration understands demonst does
inspection Whether the uterine ovoid is longitudinal or inspection will ration inspection.
transverse –to rule out lie of the festus explain

contour of the uterus cylindrical or spherical

undue enlargement of the uterus –to rule out

polyhadraminious or multiple pregnancy

skin condition of abdomen- evidence of ring worm

or scabies - To rule out any abnormality or infection
 Any incisional scar mark or injury mark.

10 Student will 2min The uterus is to be centralized if it is deviated .The By live Student will Live Student
able to do ulnar border of the left hand is placed on the demonstration understands demonst takes
measureme uppermost level of the fundus & an approximate measurement ration fundal
nt of fundal duration of the pregnancy in terms of weeks of of fundal height
height gestation height will
teach
When the fundus expands above the umbilicus the
height of uterus may be measure with tape measure
in cm
At 24 weeks of gestation the fundus is up to
umbilicus
It can also be measure by finger after 24 weeks 4
finger above umbilicus it is 28 weeks and so on

It is taken to rule out fetal wellbeing

11 Student will 3min Palpation is also called Leopold maneuvers. They By live Student will By live Student
ale to do are perform routinely after 26 weeks of gestation demonstration observe the demonst does
palpation palpation will procedure ration palpation
Fundal grip- To find out which pole of the fetus is explain & will
in fundal region understand

Lateral or umbilical grip - To find out the position of

 the back , limbs ,& the anterior shoulder

The first pelvic grip or deep pelvic palpation (if

divergence of figure is there head is engage &if
convergence of figure is there than the head is not
engage indicates ) - To palpate the part occupying
the lower part of the uterus

Second pelvic grip(Paw lick) grip) -To rule out

engagement of the head

12 Student will 2min The FHS are best audible through the back in vertex By live Student will By live Student
able to do & breech presentation where the convex portion of demonstration observe the demonst does
auscultation the back is situated.- To rule out fetal well being auscultation of procedure ration auscultatio
of FHS FHS will & will n of FHS
It can be check by stethoscope or feotoscope explain understand

Normal FHS is in between 120 to 140 /min

13 Students 2min By doing antenatal examination we come to know Question will Student will Live Student
will able to Lie, attitude, presentation, position, presenting part ask what do responds demonst does
do FHS of the fetal & also the fetal well- being. As well we come to ration conclusion
conclusion as the maternal well being. know by doing
of the antenatal
 procedure examination ?

By live Student will

demonstration understand
the topic will
conclude
14 Student will 3min Make the mother comfortable - To ensure the By live Student will Activity Student
able to comfort of the patient demonstration do after aid performs
perform after of the care after care
after care of Inform her about findings of examination patient & of the
the article will patient &
patient& Ask for any discomfort & record it show article
article
Replace all the article properly

Student will Record all the findings in the history taking & Question will Student will Activity Student
able to do assessment file ask what responds aid does
reporting & Inform any abnormalities to the superior & take reporting & reporting
recording prompt action recording you &
Record any other information that mother has given will do? recording
in the last page. Student will
Reporting & listen
recording will carefully
explain
15 Summary 3min Systematic supervision (Examination & advice) Topic will Students Verbally Student
during pregnancy is called antenatal care .ANC summarize will will
examination can be done by means of general participate summarize
examination & obstetrical examination .in general in s the topic
examination height, weight, pallor, color of skin etc summarizati
things are observed & in obstetrical examination on of topic
inspection ,palpation ,auscultation etc things are
observed to rule out maternal & fetal wellbeing.

16 Conclusion 2min ANC care is very essential component of maternal Topic will Student will Student Student
&child health services & it should be done regularly conclude listen will does
to rule out any abnormality For maternal & fetal carefully participa conclusion
well being te in
conclusi
on
17 Assignment 2min Demonstrate the procedure of palpation Ask student to Student will Live Student
To evaluate students understanding do the do the demonst does the
procedure of demonstrati ration procedure
palpation on of
palpation
BIBLIOGRAPHY
1) B. T. Basavanthappa ,Text Book of midwifery &reproductive
health nursing Jaypee Brothers PVT LIM New Delhi
2) D C Datta,Text Book of Obstetric including perinatology &
contraception New central book agency Culcutta
3) Myles ,Text Book of Midwives Edinburgh London New York