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13 Cards in this Set
- Front
- Back
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VBAC
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associated with increased risk of uterine rupture
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Possible indications for a Cesarean Birth (CB)
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dystocia, cephalopelvic disproportion, htn, maternal diseases (diabetes), active genital herpes, classic cesarean incision, persistant nonreassuring FHR patterns, prolapsed umbilical cord, fetal malpresentations, hemorrhagic conditions
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Contraindications of CB
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fetal death, fetus that is too immature to survive, maternal coagulation defects
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Maternal risks associated with CB
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infection, hemorrhage, UTI, thrombophlebitis/thromboembolism, paralytic ileus, atelectasis (lung collapse), anesthesia complications
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Fetal risks associated with CB
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inadvertent preterm birth, transient tachypnea, persistent pulmonary htn of newborn, injury such as laceration/bruising
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For CB, must confirm gestational age of at least 39 wks by:
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1. interval of at least 36 weaks since + pregnancy test 2. ultrasound between 6 & 11 wks, supports GA of at least 39wks.
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Preparations for CB
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wedge under mom's hip, single IV dose of prophylactic antibiotic such as ampicillin, clip hair around incision area, indwelling catheter inserted, secure woman's legs to table, sterile abdominal skin prep
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incisions for a CB
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1. skin incision in abdominal wall 2. uterine wall incision
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Skin incision types (2)
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1. vertical 2. pfannenstiel (transverse)
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Types of uterine incisions (3)
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1. low transverse 2. low vertical 3. classic (most likely to rupture during subsequent birth)
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Nursing Considerations for CB:
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1. emotional support for woman and partner 2. Teaching (pre-op, est. wait times, post-op) 3. Promoting safety (wedge, oral intake info.) 4. Post-op care
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Post op care for CB in PACU
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assess temp, vitals, return of motion and sensation, LOC, abdominal dressing, uterine firmness and position, lochia (quanitity, color), urine output, IV infusion, pain relief needs, encourage deep breathing and coughing
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If general anesthesia for CB assess:
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LOC and Respiratory status (skin or mucous memb color; rate and quality; O2 sats)
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