OSCE preparation

Hi, I have my OSCE on monday and am trying not to panic about it. I have been out for 6 weeks of placement in the community so have put into practice most of the skills that we were taught in the skills lab. I know how to perform the tasks but am worried about the best was to describe what I am doing/have done and what the implications are if for example the BP reading was outwith normal parameters. Any advise would be so greatly appreciated, J x

I would ask her how she is feeling. Then check her blood pressure, take her pulse. Check her urine. Then I would carry out an abdominal examination by inspection, palpation and auscultation. I would explain to her my findings and document them. I would ask if she had any worries or concerns and book her in to see me at 35-36 weeks. I would give her another bottle for the next time and arrange to discuss her birth plan too.

Can I play along? IckleJ - Im stressing out too.

here goes. Advise her she is legally entitled to time off for all her antenatal care.

Her BP is high so I would be looking at her booking bp and pulse for baselines.
As she also has Protein in her urine, I would be wanting to rule out PET so ask if she
has had any visual disturbances, any headaches that havent gone away with paracetamol
and upper epi-gastric pain?

As there is Leucocytes in her urine as well as the protein I'd want to rule out infection so ask if she caught the middle bit of pee in the sample, ask if she is having discharge as it may have contaminated the sample. Take her temp, ask if she has any symptoms of UTI, pain when urinating, back pain, feeling like she is not fully emptying her bladder when she goes to the bathroom.
Repeat the Bp measurements looking towards possibly refer to consultant unit for either pregnancy induced hypertension or possible PET.

Now I want to play along too cause no-one's mentioned her history Don't know if there's anything useful here http://www.studentmidwife.net/student-midwife-forums-2/clinical-skills-assessment-osce-viva-9/ but great what iolaus is doing for yous

Thanks Iolaus for doing this.
Please play along Binky - I need all the opinions to make sure im thinking along the right lines.

This is when I get a bit more unsure of myself.
Her BP isnt that high for her, and all back to normal now - could this be down to a bit of white coat syndrome and the fact that she was stressed and anxious about getting to her appt on time / her boss being awkward. Discuss with her, the demands of her job, risk assessment has been done and ask when she is planning to stop, make sure she is resting when able.
As she has no further signs of UTI send MSSU to lab for C&S, but advise her if symptoms appear then to contact us or GP for antibiotics and we will wait on MSSU coming back from lab and contact her if she need antibiotics.
At my placement as she is a prim we would want to see her again at 34 weeks and repeat Group and Antibodies and FBC. Birth Plan and place of birth would be discussed at 32 or 34 or 36 weeks.
ensure any questions she has have been answered.
Dont know what else but know I've missed something.

It was white coat syndrome that occurred to me, but I wondered if she could be anxious for any reason relating to being grav 1 para 0. Apart from that I've no clue!