• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

Card Range To Study



Play button


Play button




Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

29 Cards in this Set

  • Front
  • Back
Reasons for requesting a C-section
fear of labor pain
fetal moridity
maternal pelvic floor damage
more convenient to have a planned date of birth
Other factors rising incidence of C-section
Use of electronic fetal monitoring (earlier indications of fetal distress)
Increased malpractice suits
Labor induction and augmentation
Reasons for emergency C-section
failure to progress in labor
non-reassuring fetal heart rate tracings
breech presentation
placenta previa
fetal malposition
Transverse incision (lower uterine segment) is chosen for several reasons
the lower uterine segment is the thinnest portion of the uterus with the least activity, incision at this site minimizes blood loss, easier to repair, rupture of scar in subsequent pregnancies are minimized.
Transverse incision also has a decreased risk for
paralytic ileus
bowel adhesions
To perform a transverse incision (after opening the abdominal cavity), the surgeon makes the initial incision transversely across
the uterine peritoneum, where it is attached loosely just above the bladder, then he dissects the lower periotoneal flap and bladder from the uterus and incises the uterine muscle.
After performing the transverse incision,
the membranes are ruptured
the fetus is removed
the placenta is extracted
and IV oxytocin is administered to facilitate uterine contractions
Suturing (transverse) of the uterine wall occurs in
two layers, which seals off the incision and helps prevent lochia from entering the peritoneal cavity

A layer of absorbable suture is used to reapproximate the visceral peritoneum

Packs are removed from the abdominal cavity, with the abdomen closed in layers
With a CLASSIC cesarean, the surgeon makes a
VERTICAL incision directly into the wall of the uterine body

After extraction of the uterine contents, three layers of absorbable sutures are used to close the incision.
This approach (classic) requires cutting into the
full thickness of the uterine corpus.
Indications for a classic (vertical) are
extensive adhesions involving the bladder and lower uterine segment from previous C-births, transverse lie, and anterior placenta previa
Classic (vertical) provides RAPID access to the fetus and may be used in
cases of acute hemorrhage or other emergencies that threaten maternal/fetal safety
Other factors (class-vertical)
fetus less than 34 weeks who presents breech
maternal fibroids that restrict lower uterine segment
need for maternal hysterectomy immediately following
invasive maternal cervical cancer
rescue living fetus from dead mother
Rare type of incision is the
low (cervical) vertical approach. Generally used only if surgeon is having trouble extracting from other methods
Preadmission (C-Birth) should include
discussion of postoperative pain management
realistic understanding of pain and surgical recovery
warning signs of infection
Team members (heightened anxiety of pt) need to concentrate on
alleviating fears
correcting misperceptions
teaching normal procedures
likely outcomes
communicating findings
If C-section is elective, providers should
verify the pregnancy's gestation
review maternal/pregnancy history
Common diagnostic studies to ensure maternal/fetal well being include
blood type and cross match
ultrasound (fetal position/placental location)
if gestation is PRETERM (an amniocentesis may be needed to check fetal lung maturity
The doctor (c-birth) usually discusses the need
for the surgery
the risks
the type of anesthesia (spinal, epidural or general)
EPIDURAL used most frequently
The nurse (c-section) should document the mom's last
oral intake and what was eaten, assist with preparing the necessary equipment, including newborn resuscitation equipment and a warm crib
The nurse (c-section) can begin teaching inter.ventions that reduce
postoperative complications (including use of deep breathing exercises and the incentive spirometer
Team members will prepare the
surgical site and begin an IV infusion for fluid replacement therapy, the client will need a Foley for approximately 24 hours.
The nurse should administer (c-section)
any ordered preoperative medications and record when they were given as well as any side effects, gown the father.
The team typically involved in a c-birth includes the
OB, surgical assistant, anesthesiologist, registered nurses and pediatrician. Nurses are particularly helpful during this time at providing comfort, information, and reassurance to the client and her support people.
Postpartum (c-section) care
Vitals signs and lochia flow checked every 15 min for 1 hr
every 30 min for next hour and then every 4 hours if stable

If the patient received sedation, her LOC needs to be monitored; if she received general, the nurse needs to document when sedation to her legs returns
Postpartum care (con't)
The patient should cough, perform deep breathing and use the incentive spirometer every 2 hours
Assessments will include
regular assessments of her abdominal dressing and drainage
uterine fundus for firmness
urinary output
Some clients are able to
eat regular food 12-18 hours postpartum
The client should avoid sexual intercourse until
lochia has ceased and she no longer has any abdominal or perineal discomfort

provide contraception education

return appointment: 6 weeks after discharge