Woman has a fever – provide treatment and refer urgently to hospital!
Procedure:
– Insert an IV line
– Give fluids slowly
If: Applicability: ("Body temperature" ≥ 38°C)
AND ("Second body temperature" ≥ 38°C) (Should Conduct further investigation and, if necessary, refer urgently if treatment not available at your facility )
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Abnormal pulse rate – refer for further investigation
Procedure:
– Check for fever, infection, respiratory distress, arrhythmia
– Refer for further investigation
If: Applicability: 60 bpm > "Second pulse rate" > 100 bpm (Should Refer to a hospital)
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Woman has respiratory distress – refer urgently to the hospital!
If: Applicability: (((((("Respiratory exam result" = "Dyspnoea")
OR ("Respiratory exam result" = "Cough"))
OR ("Respiratory exam result" = "Rapid breathing"))
OR ("Respiratory exam result" = "Slow breathing"))
OR ("Respiratory exam result" = "Wheezing"))
OR ("Respiratory exam result" = "Rales"))
OR ("Respiratory exam result" = "Other abnormal respiratory exam result (specify)") (Should Refer urgently to a hospital)
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Woman has low oximetry (<92%) – she should be referred urgently to the hospital
If: Applicability: "Oximetry" < 92% (Should Refer urgently to a hospital 2)
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Woman's cardiac condition is abnormal and she should be referred urgently to the hospital
If: Applicability: ((((((("Cardiac exam result" = "Heart murmur")
OR ("Cardiac exam result" = "Weak pulse"))
OR ("Cardiac exam result" = "Tachycardia"))
OR ("Cardiac exam result" = "Bradycardia"))
OR ("Cardiac exam result" = "Arrhythmia"))
OR ("Cardiac exam result" = "Cyanosis"))
OR ("Cardiac exam result" = "Cold sweats"))
OR ("Cardiac exam result" = "Other abnormal cardiac exam result (specify)") (Should Refer urgently to a hospital 3)
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Woman's breast exam was abnormal and she should be referred to hospital for further investigation
If: Applicability: (((((("Breast exam result" = "Nodule")
OR ("Breast exam result" = "Discharge"))
OR ("Breast exam result" = "Flushing"))
OR ("Breast exam result" = "Local pain"))
OR ("Breast exam result" = "Bleeding"))
OR ("Breast exam result" = "Increased temperature"))
OR ("Breast exam result" = "Other breast exam result (specify)") (Should Conduct further investigation and, if necessary, refer urgently to a hospital)
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Woman's abdominal exam was abnormal and she should be referred or further evaluated
If: Applicability: ((((((((((((((((("Abdominal exam result" = "Mass/tumour")
OR ("Abdominal exam result" = "Pain on superficial palpation"))
OR ("Abdominal exam result" = "Pain on deep palpation"))
OR ("Abdominal exam result" = "Painful decompression"))
OR ("Abdominal exam result" = "Other abnormal abdominal exam result (specify)"))
OR ("Pelvic exam result (visual)" = "Abnormal vaginal discharge"))
OR ("Pelvic exam result (visual)" = "Evidence of amniotic fluid"))
OR ("Pelvic exam result (visual)" = "Foul-smelling vaginal discharge"))
OR ("Pelvic exam result (visual)" = "Clusters of erythematous papules"))
OR ("Pelvic exam result (visual)" = "Vesicles"))
OR ("Pelvic exam result (visual)" = "Genital ulcer"))
OR ("Pelvic exam result (visual)" = "Genital pain"))
OR ("Pelvic exam result (visual)" = "Tender bilateral inguinal and femoral lymphadenopathy"))
OR ("Pelvic exam result (visual)" = "Cervical friability"))
OR ("Pelvic exam result (visual)" = "Mucopurulent cervicitis"))
OR ("Pelvic exam result (visual)" = "Tender unilateral lymphadenopathy"))
OR ("Pelvic exam result (visual)" = "Curd-like vaginal discharge"))
OR ("Pelvic exam result (visual)" = "Other abnormal pelvic exam (visual) result (specify)") (Should Refer to a hospital 2)
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Woman should be referred urgently if there is evidence of amniotic fluid, which could indicate the start of labour
If: Applicability: ("Pelvic exam result (visual)" = "Evidence of amniotic fluid")
AND ("Gestational age" < 37 weeks) (Should Refer urgently to a hospital 4)
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If no fetal heartbeat is observed, inform the woman that there might be a problem and that she needs to be referred to the hospital for further examination and next steps.
Procedure:
– Inform the woman that you cannot find the heartbeat and need to refer her to check if there's a problem
– Refer to hospital
If: Applicability: ("Fetal heartbeat present" = FALSE)
AND ("Gestational age" ≥ 20 weeks) (Should Refer to a hospital 3)
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Fetal heart rate is abnormal after two readings: the woman should be referred to hospital
If: Applicability: (100 bpm > "Second fetal heart rate" > 180 bpm)
AND ("Gestational age" ≥ 20 weeks) (Should Refer to a hospital 4)
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