Ok. I think I'm okay at vaginal exams when patients are under 6cm dilated. Above that, I think I'm supposed to go by how much cervix I feel, correct? I had a patient where I found her cervix and I felt there to be
lamazeteacher 2,170 Posts Specializes in OB, HH, ADMIN, IC, ED, QI. Apr 5, 2009 If there's less than 1cm of cervix, she's 9 cm. (10-1)It's been a while since I worked L&D, but I think either way is OK - what's left or how far apart the cervix is, by feeling the head. I never stretched my fingers to see, but ran 2 fingers from one side to the other...... Speaking of stretching, don't forget to chart to where the cervix can be stretched, mostly on multips.Of course checking during a contraction is optimal. I've known a cervix to seem 6 cm. between contractions, and stretch to 8-9 during one. When we were still carting patients down the hall to the del rm, that meant a wild ride was had by all!
meluhn 661 Posts Specializes in acute rehab, med surg, LTC, peds, home c. Has 16 years experience. Apr 5, 2009 mslema,What program are you in? I never had to do this in NS. Are you in training for L&D or maybe going for your NP?
deege58 65 Posts Specializes in Labor and Delivery. Has 26 years experience. Apr 5, 2009 Honey, where is your preceptor? Are there no nurses that you feel comfortable with where you work that can help with you on your exams? We can describe what the cx feels like at 9cm but what will be helpful to you is to have someone check the pt right after you and confirm your exam. Have fun on your journey!!
romantic 194 Posts Specializes in Med-surgical; telemetry; STROKE. Has 9 years experience. Apr 7, 2009 If there's less than 1cm of cervix, she's 9 cm. (10-1)It's been a while since I worked L&D, but I think either way is OK - what's left or how far apart the cervix is, by feeling the head. I never stretched my fingers to see, but ran 2 fingers from one side to the other...... Speaking of stretching, don't forget to chart to where the cervix can be stretched, mostly on multips.Of course checking during a contraction is optimal. I've known a cervix to seem 6 cm. between contractions, and stretch to 8-9 during one. When we were still carting patients down the hall to the del rm, that meant a wild ride was had by all!Lamazeteacher, please explain about stretching. Thank you.
romantic 194 Posts Specializes in Med-surgical; telemetry; STROKE. Has 9 years experience. Apr 7, 2009 Honey, where is your preceptor? Are there no nurses that you feel comfortable with where you work that can help with you on your exams? We can describe what the cx feels like at 9cm but what will be helpful to you is to have someone check the pt right after you and confirm your exam. Have fun on your journey!!I am in a training program right now. And often I see myself in the situation when I have to give my best guess because the patient is uncomfortable (before epidural) and my preceptors feel that it will be inappropriate to repeat the VE to recheck my results. Therefore I am, kind of, blindfolded :) Therefore I also appreciate your help and advice.
deege58 65 Posts Specializes in Labor and Delivery. Has 26 years experience. Apr 7, 2009 Lamazeteacher, please explain about stretching. Thank you.I am interested in hearing this as well....I have been doing l and d about 18 years and havent heard of documenting where you can stretch the cx to....when you perform a v.e. you are supposed to refrain from stretching the cx to determine dilation; if shes 4 and you can stretch her to 6, she's still 4, is she not?
