CHECKLIST ON

Objective Structured Clinical

Examination (OSCE)

Submitted to- Mrs. Somibala Thokchom

Tutor
Rufaida College of Nursing
Submitted by- Ms. Sneha Sehrawat
M.Sc. Nursing IInd year
OBG
Rufaida College of Nursing

Procedure - Postnatal Examination

Objective Structured Clinical Examination (OSCE)

Participant Number : ______________ Date : _______________

Skill Station : Abdominal Examination during pregnancy

Situation : This woman Meena a 26-year-old, G2P2L1A1 with previous

abortion at 2 months. She has delivered 7 days back and given birth to
healthy male baby weighing 3.9 kgs. In this pregnancy and has no major
medical problems overall. She has been planned for discharged 3 days
back. She comes today for routine visit. You have already conducted the
history and have found nothing abnormal. Previously she has had a
normal complete physical exam. Now you will conduct the head to toe
postnatal examination with attention to the goals for postnatal mother.

Observation : Observe if the participant is performing the following

steps of postnatal examination in their correct sequence (as necessary)
and technique. Score “1” for each point conducted correctly or mark “0”
if the task is not done or incorrectly.

S.No. Criteria/ Steps Score (1/0) Remarks

1. Wash hands and communicates with
woman .
2. Explain the procedure to the mother.
3. Instruct the mother to empty the bladder and
to wash the perineum with warm water.

4. Place the mother in supine position with

hands at the sides and legs straight.

5. Drape the mother.

6. Bring the mother towards the examiner and

ask the mother to be relaxed.

7. Prepare all the necessary articles.

a) A large enamel tray containing:-
b) Large sheet to drape the client.
c) Draw sheet to drape the client.
d) Stethoscope to auscultate chest and
bowel sounds.
e) Torch to visualize eyes, ears and
mouth.
f) Bowl with gauze piece to clean the
breast.
g) Paper bag to discard the solid waste.
h) Inch tape to measure fundal height.
i) Pen and paper to record the
findings.
8. Prepare the environment
i. Select a clam and quite environment.
ii. Provide privacy.
9. PROCEDURE:-
 Before taking the history recording,
create a calm and quite atmosphere
so that the postnatal mother feel is
relaxed and comfortable.
 To have full cooperation, explain the
procedure for postnatal examination.
 Ensure privacy and maintain
confidentiality.
 Highlight any abnormal findings.
 Record all facts accurately in the
postnatal card.
 The matrix can be used to record the
detail history of the postnatal mother.
10. Vital Signs:-
Blood pressure, pulse, respiration and
temperature must be monitor accurately.
11. General Appearance:-
 Body build should be seen for
appearance i.e. how it is looks.
 Activity should be monitoring that
whether it is dull or active.
 Nourishment should be seen in postnatal
mother that whether she is well
nourished, under nourished and poor
nourished.
12. Skin:-
 Assess the patient skin colour.
 Assess the patient skin for turgor i.e. any
rashes, lesion
13. Head:-
 Scalp should be assessed for dandruff
and cleanliness and any pediculi.
 Hair texture for roughness and dryness.
14. Face:-
The mother face should be observed for
wrinkles, puffiness and scars.
15. Eye:-
Palpebral conjunctiva for paler, sclera for
jaundice and eyes for evidence of infection.
16. Nose
Deviated nasal septum, infection and
blockage.
17. Mouth
Observe tongue for pallor, glossitis ( vitamin
deficiencies), teeth and gums for caries,
stomatitis, tonsil for tonsillitis.
18. Ear
Infection ,blockage, wax
19. Neck
Observe neck veins, thyroid glands, lymph
glands for any abnormalties.
20. BREAST EXAMINATION:-
 Expose only the needed area that is one
breast at a time.
 Inspect for the engorged veins, redness.
 Inspect nipple for retracted, erect,
cracked, crust formation.
21. PALPATION:-
 Feel for warmth
 Palpate from the periphery to the centre
with finger pads in a circulatory motion
 Palpate for any masses/ lumps, hardness
 While palpating for axillary tails,
 instruct the to raise the hands above the
shoulder level
 Express the colostrums/ milk and wipe
with gauze piece
 Repeat this for the other side.
22. ABDOMINAL EXAMINATON

Inspection
Cover the chest with draw sheet and expose
only the abdomen. Similarly use the other
sheet to cover up the pelvic region. Inspect
the abdomen for consistency, presence of
any wound( LSCS, PPS) and if present
assess the condition of the wound.

Palpation
Start from the xiphisternum down, feel for
the uterine fundus. Place the ulnar border of
the hand. Feel for the upper border of the
symphysis pubis, place inchtape inch part up
and measure the symphysis fundul height.
Feel the consistency of the uterus-hard/well
contracted and flabby.

Auscultation
Auscultate for bowel sound.
23. Extremities
Eliciting human’s sign
Ask the mother to flex the leg at the knee
level and relax. Support at the calf muscle
with other hand dorsiflex the foot. If the
mother experiences pain at the calf region
then homan’s sign is positive.
24. Examination of the perineum
-Position client in lithotomy/ dorsal
recumbent position.
-Drape the client.
-Put the light on.
-Wash hands.
-Wear gloves
-Examine the perineum for-
 Condition of episiotomy
wound( REEDA)
 Colour and amount of lochia.
 Condition of perineum,
 Number of pads changed/day
25. AFTER CARE:-

Client/patient
 Explain the findings.
  Help her to dress up.
 Remove the drappings.
 Position comfortably.

Articles
 Wash and replace the articles.
 Wash hands.

Environment
 Put off the light.
 Keep the bed/table clean.
 Dispose the waste
26. RECORDING:-
Record the findings in nurse’s record with
date and time.
Vital signs record in the vital signs chart
27. Explain the findings to the mother and
reassure her.

Pass Score = 22/27 (83%)

Student Score = _________

Pass – Yes No