WHO Antenatal Care Guideline Implementation Guide
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WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-anc/ and changes regularly. See the Directory of published versions

: ANC.DT.04 Conducting physical exams - XML Representation

Active as of 2021-06-11

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<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="ANCDT04"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    <table class="grid dict">
        
        <tr>
            <th scope="row"><b>Id: </b></th>
            <td style="padding-left: 4px;">ANCDT04</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Url: </b></th>
            <td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT04.html">ANC.DT.04 Conducting physical exams</a></td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Version: </b></th>
            <td style="padding-left: 4px;">0.3.0</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Identifier: </b></th>
            <td style="padding-left: 4px;">
                
                
                <p style="margin-bottom: 5px;">
                    <b>value: </b> <span>ANC.DT.04</span>
                </p>
                
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Name: </b></th>
            <td style="padding-left: 4px;">ANCDT04</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Title: </b></th>
            <td style="padding-left: 4px;">ANC.DT.04 Conducting physical exams</td>
        </tr>
        
        
        
        <tr>
            <th scope="row"><b>Status: </b></th>
            <td style="padding-left: 4px;">active</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Experimental: </b></th>
            <td style="padding-left: 4px;">false</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Type: </b></th>
            <td style="padding-left: 4px;">
                
                    
                        
                        <p style="margin-bottom: 5px;">
                            <b>system: </b> <span><a href="http://terminology.hl7.org/5.5.0/CodeSystem-plan-definition-type.html">PlanDefinitionType</a></span>
                        </p>
                        
                        
                        <p style="margin-bottom: 5px;">
                            <b>code: </b> <span>eca-rule</span>
                        </p>
                        
                        
                    
                
                
            </td>
        </tr>
        
        
        
        <tr>
            <th scope="row"><b>Date: </b></th>
            <td style="padding-left: 4px;">2021-06-11 22:32:40-0600</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Publisher: </b></th>
            <td style="padding-left: 4px;">World Health Organization (WHO)</td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Description: </b></th>
            <td style="padding-left: 4px;">Depending on the results of some physical exams, additional examinations or repeat measurements are required</td>
        </tr>
        
        
        
        
        <tr>
            <th scope="row"><b>Use Context: </b></th>
            <td style="padding-left: 4px;">
                <table class="grid-dict">
                    <tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>
                    
                      <tr>
                        <td>task</td>
                        <td>ANC.B8</td>
                        <td>Conduct physical exam</td>
                      </tr>
                    
                </table>
            </td>
        </tr>
        
        
        <tr>
            <th scope="row"><b>Jurisdiction: </b></th>
            <td style="padding-left: 4px;">001</td>
        </tr>
        
        
        
        
        
        
        
        

        
        <tr>
          <th scope="row"><b>Libraries: </b></th>
          <td style="padding-left: 4px;">
            <table class="grid-dict">
              
                <tr><td><a href="Library-ANCDT04.html">ANC.DT.04 Conducting physical exams</a></td></tr>
              
            </table>
          </td>
        </tr>
        

        
        <tr>
          <th scope="row"><b>Actions: </b></th>
          <td style="padding-left: 4px;">
            <table class="grid-dict">
              
                <tr>
                  <td>
                    <b> ANC.DT.04 Conducting physical exams:</b> <br/>
                    <b>When:</b> <i>named-event:</i> ANC.B8 Conduct physical exam<br/>
                    
                    
                      <b>Then:</b>
                      <table class="grid-dict">
                        
                          <tr>
                            <td>
                              Given high values (SBP ≥ 140 or DBP ≥ 90) upon first measure, blood pressure should be measured again<br/>
                              
                              <b>If:</b> <i>applicability:</i> (&amp;quot;Systolic blood pressure&amp;quot; ≥ 140 mmHg)
  OR (&amp;quot;Diastolic blood pressure&amp;quot; ≥ 90 mmHg) <i>(Should Measure BP again after 10–15 minutes rest)</i><br/>
                              
                                
                              
                            </td>
                          </tr>
                        
                          <tr>
                            <td>
                              The health worker should retake the woman's temperature if the first reading is over 38°C<br/>
                              
                              <b>If:</b> <i>applicability:</i> &amp;quot;Body temperature&amp;quot; ≥ 38°C <i>(Should Measure temperature again)</i><br/>
                              
                                
                              
                            </td>
                          </tr>
                        
                          <tr>
                            <td>
                              The health worker should retake the woman's pulse rate if the first reading is lower than 60 or higher than 100 beats per minute<br/>
                              
                              <b>If:</b> <i>applicability:</i> 60 &amp;gt; Pulse rate &amp;gt; 100 <i>(Should Check again after 10 minutes rest)</i><br/>
                              
                                
                              
                            </td>
                          </tr>
                        
                          <tr>
                            <td>
                              If the woman has an abnormal respiratory exam result or respiratory distress, conduct oximetry test<br/>
                              
                              <b>If:</b> <i>applicability:</i> ((((((&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Dyspnoea&amp;quot;)
  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Cough&amp;quot;))
  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Rapid breathing&amp;quot;))
  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Slow breathing&amp;quot;))
  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Wheezing&amp;quot;))
  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Rales&amp;quot;))
  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Other abnormal respiratory exam result (specify)&amp;quot;) <i>(Should Conduct oximetry test)</i><br/>
                              
                                
                              
                            </td>
                          </tr>
                        
                          <tr>
                            <td>
                              Fetal heart rate out of normal range (100–180) – please have the woman lay on her left side for 15 minutes and check again<br/>
                              
                              <b>If:</b> <i>applicability:</i> 100 bpm &amp;gt; Fetal heart rate &amp;gt; 180 bpm <i>(Should Measure the fetal heart rate again)</i><br/>
                              
                                
                              
                            </td>
                          </tr>
                        
                      </table>
                    
                  </td>
                </tr>
              
            </table>
          </td>
        </tr>
        
    </table>
</div>
  </text>
  <url value="http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT04"/>
  <identifier>
    <use value="official"/>
    <value value="ANC.DT.04"/>
  </identifier>
  <version value="0.3.0"/>
  <name value="ANCDT04"/>
  <title value="ANC.DT.04 Conducting physical exams"/>
  <type>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
      <code value="eca-rule"/>
    </coding>
  </type>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2021-06-11T22:32:40-06:00"/>
  <publisher value="World Health Organization (WHO)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="https://www.who.int"/>
    </telecom>
  </contact>
  <description
               value="Depending on the results of some physical exams, additional examinations or repeat measurements are required"/>
  <useContext>
    <code>
      <system
              value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
      <code value="task"/>
      <display value="Workflow Task"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system
                value="http://fhir.org/guides/who/anc-cds/CodeSystem/activity-codes"/>
        <code value="ANC.B8"/>
        <display value="Conduct physical exam"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <library value="http://fhir.org/guides/who/anc-cds/Library/ANCDT04"/>
  <action>
    <title value="ANC.DT.04 Conducting physical exams"/>
    <trigger>
      <type value="named-event"/>
      <name value="ANC.B8 Conduct physical exam"/>
    </trigger>
    <action id="1">
      <title value="Measure BP again after 10–15 minutes rest"/>
      <description value="Measure BP again after 10–15 minutes rest"/>
      <textEquivalent
                      value="Given high values (SBP ≥ 140 or DBP ≥ 90) upon first measure, blood pressure should be measured again"/>
      <documentation>
        <type value="citation"/>
        <label
               value="Managing complications guide (IMPAC) (2017): Section S-51 (5)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description
                       value="(&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
  OR (&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)"/>
          <language value="text/cql-identifier"/>
          <expression
                      value="Should Measure BP again after 10–15 minutes rest"/>
        </expression>
      </condition>
    </action>
    <action id="2">
      <title value="Measure temperature again"/>
      <description value="Measure temperature again"/>
      <textEquivalent
                      value="The health worker should retake the woman's temperature if the first reading is over 38°C"/>
      <documentation>
        <type value="citation"/>
        <label
               value="Managing complications guide (IMPAC) (2017): Section S-113 (5)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description value="&quot;Body temperature&quot; ≥ 38°C"/>
          <language value="text/cql-identifier"/>
          <expression value="Should Measure temperature again"/>
        </expression>
      </condition>
    </action>
    <action id="3">
      <title value="Check again after 10 minutes rest"/>
      <description value="Check again after 10 minutes rest"/>
      <textEquivalent
                      value="The health worker should retake the woman's pulse rate if the first reading is lower than 60 or higher than 100 beats per minute"/>
      <documentation>
        <type value="citation"/>
        <label
               value="Managing complications guide (IMPAC) (2017): Section S-1 (5)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description value="60 &gt; Pulse rate &gt; 100"/>
          <language value="text/cql-identifier"/>
          <expression value="Should Check again after 10 minutes rest"/>
        </expression>
      </condition>
    </action>
    <action id="4">
      <title value="Conduct oximetry test"/>
      <description value="Conduct oximetry test"/>
      <textEquivalent
                      value="If the woman has an abnormal respiratory exam result or respiratory distress, conduct oximetry test"/>
      <documentation>
        <type value="citation"/>
        <label
               value="Managing complications guide (IMPAC) (2017): Section S-149 (5)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description
                       value="((((((&quot;Respiratory exam result&quot; = &quot;Dyspnoea&quot;)
  OR (&quot;Respiratory exam result&quot; = &quot;Cough&quot;))
  OR (&quot;Respiratory exam result&quot; = &quot;Rapid breathing&quot;))
  OR (&quot;Respiratory exam result&quot; = &quot;Slow breathing&quot;))
  OR (&quot;Respiratory exam result&quot; = &quot;Wheezing&quot;))
  OR (&quot;Respiratory exam result&quot; = &quot;Rales&quot;))
  OR (&quot;Respiratory exam result&quot; = &quot;Other abnormal respiratory exam result (specify)&quot;)"/>
          <language value="text/cql-identifier"/>
          <expression value="Should Conduct oximetry test"/>
        </expression>
      </condition>
    </action>
    <action id="5">
      <title value="Measure the fetal heart rate again"/>
      <description value="Measure the fetal heart rate again"/>
      <textEquivalent
                      value="Fetal heart rate out of normal range (100–180) – please have the woman lay on her left side for 15 minutes and check again"/>
      <documentation>
        <type value="citation"/>
        <label value="Managing complications guide (IMPAC) (2017): C-89 (5)"/>
      </documentation>
      <condition>
        <kind value="applicability"/>
        <expression>
          <description value="100 bpm &gt; Fetal heart rate &gt; 180 bpm"/>
          <language value="text/cql-identifier"/>
          <expression value="Should Measure the fetal heart rate again"/>
        </expression>
      </condition>
    </action>
  </action>
</PlanDefinition>