Ob Ch 24 C-Section

Front 1

Why is a sonogram useful to the doc before making the incision for a cesarean?

Back 1

Sonogram helps locate the placenta to avoid an accidental incision of this organ and also helps determine fetal presentation & maturity.

Front 2

Why is it important that you assess the patient for urinary output after surgery?

Back 2

Urinary output must be assessed to determine the presence of urinary retention, overextension of bladder capacity, and potential for permanent bladder damage, and to avoid interference w/ uterine contractions that may lead lead to postpartal hemorrhage. Voiding also provides evidence of adequate urinary & circulatory function.

Front 3

What are some maladaptations that can occur in the mom after a cesarean if her pain is not controlled?

Back 3

1. Pneumonia = pain minimizes activity, allowing secretions in lung to pool. Pain increases when performing respiratory toilet.

2. Thrombophlebitis = pain discourages walking, leading to venous stasis & poor circulation of the femoral veins.

3. Interference With Maternal-Infant Bonding = experiences of pain lessen tactile stimulation, which hampers the bonding process.

Front 4

What are two supportive pain control methods that can be used after a cesarean?

Back 4

1. Transcutaneous Electrical Nerve Stimulation (TENS) = method of controlling pain sensation by use of electrodes on the skin or irritate/stimulate the large afferent (sensory) nerve fibers, which facilitates the gating theory. The unit is turned on & off by Pt.

2. Patient-Controlled Analgesia (PCA) = pain contorl device.

Front 5

What is the amount of blood lost during a cesarean vs. vag birth?

Back 5

Vaginal Birth = loses 300-500 mL

Cesarean Birth = loses 500-1000 mL

Front 6

Classic Cesarean Incision
Dehiscence
Low Segment Incision
No-Indicated-Risk Cesarean Birth

Back 6

Classic Cesarean Incision = Vertical midline incision of the upper segment of the uterus

Dehiscence = rupture of the incision

Low Segment Incision = transverse incision in the supracervical portion of the uterus

No-Indicated-Risk Cesarean Birth = cesarean birth performed to avoid stress incontinence.

Front 7

Establishing surgical risk assessment includes what?

Back 7

Nutritional Status
Age
General Health
Fluid & Electrolyte Balance
Psychological Condition

Front 8

What does assessment before surgery include?

Back 8

Vitals
Urinalysis
Blood studies (CBC)
Electrolytes
Blood Typing & Cross-matching
Sonography

Front 9

Is "once a cesarean, always a cesarean" true?

Back 9

No. As long as cephalopelvic disproportion does not exist & the previous incision was a low transverse one.

Front 10

What is a major intervention after a cesarean birth?

Back 10

Early ambulation to prevent complications. Incisional pain may make this difficult, so strong nursing support & adequate pain management are necessary.