The nurse is preparing to perform Leopold maneuvers on a client who is pregnant.
The nurse understands that the purpose of this procedure is to
The nurse is preparing to perform Leopold maneuvers on a client who is pregnant.
The nurse understands that the purpose of this procedure is to
A. determine the location and presentation of the fetus.
[85%]
B. prevent compression to the inferior vena cava.
[10%]
C. measure the involution progress of the uterus.
[3%]
D. assess whether the amniotic sac has ruptured.
[2%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Antepartum
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Ante/Intra/Postpartum and Newborn Care
Item Type
Item Type
Knowledge/Comprehension
Explanation
Choice A is correct. Leopold maneuvers is a non-invasive technique that uses palpation through the abdominal wall to determine the presentation and location of the fetus. These maneuvers are typically done after 24 weeks but should be done in about 36 weeks for a more accurate assessment.
Choice B is incorrect. While it is important to prevent compression of the inferior vena cava (IVC) during pregnancy, Leopold maneuvers are not performed for this purpose.
Choice C is incorrect. Involution is the process by which the uterus returns to its normal size after childbirth. Leopold maneuvers are not used to measure involution progress, as they are typically performed during pregnancy to assess fetal position and well-being.
Choice D is incorrect. Leopold maneuvers are not used to assess whether the amniotic sac has ruptured. The nurse might perform a sterile speculum examination or a nitrazine test to determine if the membranes have ruptured, but Leopold maneuvers are not a reliable method for this assessment.
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Additional Info
✓ Leopold maneuvers is a series of tests that are done to determine the fetal location and presentation.
- First maneuver—Palpate the uterine fundus. Use the flat palmar surface of hands, with fingers together, using gentle but firm pressure to perform palpation. The breech (buttocks) is softer and more irregular in shape than the head. Moving the breech also moves the fetal trunk. The head is harder and has a round, uniform shape. The head can be moved without moving the entire fetal trunk. Distinguishes between a cephalic and breech presentation. If the fetus is in a cephalic presentation, the breech is felt in the fundus. If the presentation is breech, the head is felt in the fundus.
- Second maneuver—Hold the left hand steady on one side of the uterus while palpating the opposite side of the uterus with the right hand. With the right hand, palpate at the uterine fundus and progress downward toward the symphysis pubis. Then hold the right hand steady while palpating the opposite side of the uterus with the left hand. The fetal back is a smooth, convex surface. The fetal arms and legs feel nodular, irregular, or protruding, and the fetus often moves them during palpation. Determines on which side of the uterus is the fetal back and on which side are the fetal arms and legs (“small parts”).
- Third maneuver (Pallach’s maneuver or grip)—Palpate the suprapubic area. Attempt to grasp the presenting part gently between the thumb and middle finger. If the presenting part is not engaged, the grasping movement of the fingers moves it upward in the uterus. If the presenting part is engaged, it remains fixed and difficult to move. If a breech was palpated in the fundus, expect a hard, rounded head in this area. Confirms the presentation determined in the first maneuver. Determines whether the presenting part is engaged (widest diameter at or below zero station) in the maternal pelvis.
- Omit the fourth maneuver if the fetus is in a breech presentation. It is performed only in cephalic presentations to determine whether the fetal head is flexed.
✓ After performing Leopold maneuvers, the nurse should accurately document the findings, including the fetal lie, presentation, and engagement.
✓ Leopold maneuvers can be a novel and potentially anxiety-provoking experience for some clients, especially if they are unfamiliar with the procedure. The nurse should take the time to explain the purpose and process of Leopold maneuvers, answer any questions the client may have, and provide reassurance and support throughout the procedure. This can help to reduce anxiety and promote a sense of comfort and trust.
