Assessment of newborn condition on Apgar scale.
Task for students: conduct for this newborn assessment on Apgar scale . In the same time make a description for examiner, what are You doing.
Time for demonstration is 5 minutes.т.
Information for the examine:assess, please, the student’s actions, separately, on the every below given item.
| 1 | Wash a hands . Dry with disposable towel ,put on a sterile gloves. | 1 | 0,5 | 0 |
| 2 | After a newborn delivery to count of frequency of fetus heart beating . Frequency of heart beating more , than 100 beats in one minute -- 2 balls, less, than 100 beats in one minute – 1 ball, absent - 0 balls. | 1 | 0,5 | 0 |
| 3 | Count the frequency of respiratory movements. .Frequency of respiratory movements of newborn more ,than 40 – 50 in minute( loud cry) - 2balls , less , than 40 – 1ball, breathing is absent – 0 ball. | 1 | 0,5 | 0 |
| 4 | Check and assess of reflected irritability. Active movements, loud cry – 2 balls, movement of grimes on the face of newborn - 1 ball , absence of reaction – 0 balls. | 1 | 0,5 | 0 |
| 5 | Assess the skin cover condition. Skin cover is pink – 2 balls , acre cyanosis – 1ball, expressed of skin pale color 0 balls.. | 1 | 0,5 | 0 |
| 6 | Assess the muscle tonus of newborn. Active movements of newborn – 2 balls, the light degree of extremities flexed -1 ball, absent of movements – 0 balls. | 0,5 | 0 | |
| 7 | Assess the condition of newborn on the sum of balls during the 1 minute after delivery. | 1 | 0,5 | 0 |
| 8 | Assess the condition of newborn on the sum of balls in 5 minutes after delivery. | 1 | 0,5 | 0 |
| 9 | According to sum of balls to make a conclusion about of fetus condition, absence or presence of asphyxia . | 1 | 0,5 | 0 |
| 10 | Take away of gloves , through its in special container for utilization.. Wash a hands. | 1 | 0,5 | 0 |
Maximum quantity of balls – 10.
Consultation on the post partum contraception.
Task for the student:: perform for this patient consultation on the post partum contraception Describe, simultaneously, what You are doing.
The time of demonstration is 5 minutes.
Information for the examine:assess, please, the student’s actions, separately, on the every below given item.
| № | Criterion of the assessment. | 1,0 | 0,5 | 0 |
| 1 | To greet a patient respectfully and benevolently .Ask her to take the lovely pose .Represent yourself. To explain her that all information will be cconfidentiality. | 1,0 | 0,5 | 0 |
| 2 | Ask a patient , when she is planning the next labour or not planning at All. | 1,0 | 0,5 | 0 |
| 3 | Collect a common and reproductive anamnesis of patient: age and condition in family , quantity of pregnancies and labor , quantity of alive children , their age and sex , which methods of family planning were used before, how long, reasons of interruption to use its . | 1,0 | 0,5 | 0 |
| 4 | Give the short information about all methods of contraception , its characteristic , effectiveness, side effects. It is should be remember , that patient has a rule of choosing of contraception method . | 1,0 | 0,5 | 0 |
| 5 | To assess a somatic status and check , may be woman already has pregnancy. | 1,0 | 0,5 | 0 |
| 6 | If a patient choose the concrete method of contraception, ask her , what she knows about this method , explain for her any wrong information or not exact information. | 1,0 | 0,5 | 0 |
| 7 | Make an instruction about “ alarming” symptoms and signals , demanding the urgent going to doctor : delay of menstruation after prolonged using, sever pains in low part of abdomen , head ache , heavy bleeding, worst vision. | 1,0 | 0,5 | 0 |
| 8 | Ask a patient to repeat of instruction , to be shoe at the right way of information assessment . | 1 | 0,5 | 0 |
| 9 | Ask a patient about her questions, if she is not shoe about method. Answer on this questions. | 1,0 | 0,5 | 0 |
| 10 | Give for her another date for attendance. Give for her advice to come to doctor in any time , if she will have any problems or she will have a question. | 1,0 | 0,5 | 0 |
Maximum quantity of collected balls – 10
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ГЛАВА VI
TEST ‘S TASKS.
Test 1. At the chapter of special anamnesis of pregnant woman / parturient there don’t presence date about particularity:
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1. menstrual function
2 .sexual function
3. Generative function
4 .gynecological diseases at the past
5 duration of the present pregnancy
Test 2. Coordination of the presenting part to the plains of small pelvis is determinate by such method of examination , as
1.pelviometry
2. methods of Leopold - Levitsky
3.examination in speculum
4.internal obstetrical examination
5. bi – manual examination
Test 3. The strait size of the plane of inlet in small pelvis is coordinated with conjugate:
1.anatomic
2.true
3.diagonal
4.lateral
5.oblique
Test 4. The main method of detection of the presenting part is:
1. internal obstetrical examination
2.examination in speculum
3. method of Leopold - Levitsky
4. the third method of Leopold - Levitsky
5. the forth method of Leopold - Levitsky
Test 5. Measurement of the circumference of abdomen is performing on the level of :
1 upper angle of Michaels rhomb
2. upper angle of Michaels rhomb , umbilicus
3. crests of iliac bones, fundus of uterus
4. crests of iliac bones, umbilicus
5 crests of iliac bones, upper part of pubis
Test 6. Sizes of pelvis : 25x28x30x20 sm, Solovjev index – 15 sm. On the base of this date count , please, the true conjugate :
1. 8 sm.
2. 9 sm.
3. 10 sm
4. 11sm
5. 12 sm
Test 7. Sizes of pelvis : 24x27x29x180 sm, Solovjev index –13, 5 sm. On the base of this date count , please, the true conjugate :
1. 8 sm.
2. 9 sm.
3. 10 sm
4. 11sm
5. 12 sm
Test 8.
Prime pare of 28 years old . Term of pregnancy is – 40 weeks. Circumference of abdomen is – 96 sm, height of fundus is – 32 sm. On a base of these date count, please, the previous mass of fetus on Yakubov:
1. 3200, 0.
2. 3400, 0.
3. 3600, 0.
4. 3800, 0.
5. 4000, 0.
Test 9. Prime pare of 28 years old. Term of pregnancy is – 40 weeks. Circumference of abdomen is – 96 sm, height of fundus is – 32 sm. On a base of these date count, please, the previous mass of fetus on Jordanian formula:
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1. 2880, 0.
2. 3072, 0.
3. 3230, 0.
4. 3688, 0.
5. 4152, 0.
Test 10. Distаntia spinarum – is the distance between:
1. anterior – inferior spines of iliac bones
2. posterior – inferior spines
3. anterior –superior spines
4. posterior – superior spines
5. middle of pubis and upper angle of Michaels rhomb
Test 11. Index of Solovjov is:
6. circumference of abdomen
7. height of fundus standing
8. distance between the middle of pubis and upper angle of Michaels rhomb
9. circumference of wrist articulation
10. it is the true conjugate
Test 12. Methods of Leopold - Levitsky determinate all, except for:
1. previous mass of fetus
2. position of fetus
3. types of fetus position
4. site of fetus
5. presenting part
Test 13. During of the external obstetrical examination doctor is standing with his face to the patient to the right:
6. during performing of the first method Leopold - Levitsky
7. during performing of the second method Leopold - Levitsky
8. during performing of third method Leopold - Levitsky
9. during performing of the forth method Leopold - Levitsky
10. during performing of second method
Test 14. Before of fetus auscultation it is necessary to perform:
1. external obstetric examination
2. pelviometry
3. determination of the Solovjov index
4. determine the previous od fetus mass
5. vaginal examination
Test 15. The third method of Leopold – levitsky is for determination of
1. view of fetus
2. presenting part
3. position of fetus
4. site of fetus
5. fetus heart beating
Test 16. The second method of Leopold – levitsky is for determination of
1. position of fetus
2. view of fetus
3. view and position of fetus
4. presenting part
5. position of the small of fetus parts
Test 17. In cases of determination of previous mass of fetus on Jonson method the formula is using
1. (HFS-11)×155
2. CA×HFS
3. CA×1/2×HFS
4. (CA+HFS)×100/4
5. HFS×length of fetus in uterus
Test 18. If circumference of wrist is 15,5 sm and more , the determination of the true conjugate from the external conjugate we should minus:
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1. 6 sm
2. 7sm
3. 8sm
4. 9sm
5. 10sm
Test 19.Which method of Leopold – Levitsky will determinate symptom of “ ballots of a head” in cases of cephalic presentation:
1. the first
2. the second
3. the third
4. the forth
5. the fifth
Test 20. According which size it is possible to tell about the size of conjugate true :
1. Distantia spinarum
2. Distantia trochanterica
3. Distantia cristarum
4. Conjugata externa
5. Conjugata interna
Test 21 Coordination of fetus extremities to his head and body is :
1. site of fetus
2. position of fetus
3. parts of fetus coordination
4. view of fetus
5. presenting part
Test 22 In cases of determination of previous mass of fetus according to Yakubov method there is a formula :
1. (HFS-11)×155
2. CA×HFS
3. CA×1/2×HFS
4. HFS× length of fetus in uterus
5. (CA+HFS)×100/4
Test 23.For detection of a labor date there is a formula:
1. Negele
2. Jordanian
3. Yakubov
4. Rudakov
5. Stroykova
Test 24. The more exact method for detection of term of pregnancy is :
1. USI in any term of pregnancy
2 .counting from the first day of fetus movement
3. counting on the date of ovulation
4. objective date of examination during the first visit
5. counting from the day of last mensuration
Test 25. If suture longitudinal is at the transvers size of plane of inlet and displacement its to anterior and spin of fetus is to the left is diagnosed : 1. 1-я позиция, передний вид
2. 1-st position, posterior asynclitism
3. the second position , posterior view
4. the second position anterior asynclitism
5. cephalic presentation , the 2 position
Test 26.Presenting part may be found, using method :
1. the I method of Leopold - Levitsky
2. the IV method of Leopold - Levitsky
3. the II method of Leopold - Levitsky
4. the III method of Leopold - Levitsky
5. all methods of Leopold - Levitsky
Test 27. During examination of malty gravid of 30 years , using the external methods it was found : fundus of uterus is on the level of sternal , height of fundus on 36 sm., circumference of abdomen is - 95 sm. What is the term of pregnancy according to these date:
1. 28weeks
2. 26 weeks
3. 32 weeks
4. 36 weeks
5. 40 weeks
Тест 28.Presenting part is a head , back is situated to posterior and to the left- it is:
1. cephalic presentation .the I position
2. cephalic presentation .the I position, posterior view
3. cephalic presentation .the II position, posterior view
4. cephalic presentation .the II position, anterior view
5. cephalic presentation .the II position
Test 29. Coordination of the large of fetus part to the plane of inlet is:
1. site of fetus
2.position of fetus
3 coordination of the small parts
4.view of fetus
5.presenting part
Test 30. There are date of internal obstetrical examination in cases of occipital presentation , the I position:
1. suture longitudinal is at the transverse size , small fontanel to the left
2. suture longitudinal is at the transverse size , small fontanel to the right
3.suture longitudinal is at the strait size, small fontanel to the anterior
4. .suture longitudinal is at the strait size, small fontanel to the posterior
5. suture longitudinal is at the transverse size, going to the posterior
ЭТАЛОНЫ ОТВЕТОВ
1 - 5 16 - 1
2 - 4 17 - 1
3 - 2 18 - 5
4 - 1 19 - 3
5 - 2 20 - 4
6 – 4 21 - 3
7 - 3 22 - 4
8 - 3 23 - 4
9 - 2 24 - 4
10 – 3 25 - 2
11 – 4 26 - 4
12 – 4 27 - 4
13 – 4 28 - 2
14 – 1 29 - 5
15 – 2 30 - 1
Список ИСПОЛЬЗОВАННОЙ литературы
1.Государственный общеобразовательный стандарт образования Республики Казахстан. Образование высшее профессиональное. Специальность 051301 – «Общая медицина». Министерство здравоохранения Республики Казахстан. Астана, 2006 – 93с.
2.Основные клинические протоколы и приказы МЗ РК по акушерству и неонатологии. - Алматы, 2010. – 172с.
3.Под редакцией Кайлюбаевой Г.Ж. Практические навыки по акушерству и гинекологии. – г. Семипалатинск, 2003. – 36с.
4.Типовая учебная программа. Производственная практика помощник врача-ординатора. IV курс, по специальности 051301 – Общая медицина. Министерство здравоохранения Республики Казахстан. Астана, 2010 – 66 с.
5.Эффективная перинатальная помощь и уход. Акушерство, руководство для участника. ВОЗ, Женева, 2007г.
6.Эффективная перинатальная помощь и уход. Руководство для участника. ВОЗ, Женева, 2007г.
Практические навыки
По акушерству и гинекологии
(на русском, казахском, английском языках)
Методическое пособие
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