Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Exams > C-section > Flashcards

C-section Flashcards

1
Q

What is a c-section

A

Birth of an infant through a transabdominal and uterine incisoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Reasons why c -sections are becoming more popular?

A 
Fear of uterine rupture w VBAC
Avoid pain from vaginal birth
Avoid trauma to pelvic floor
Ability to schedule birth
Nulliparous women requesting CS after 39 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Actual indications to do csection?

A

Any major reason to not to the vaginal birth really
Complete placenta previa
Active genital herpes
HIV + with high viral load
Hypertensive rate making patient unable to be induced
Repeat CS

OR emergencies
fetal distress, placenta abruptio, uterine rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Does vaginal birth or c section have higher mortality?

Which is usually more expensive?

A

C section 3.6x more

The c section bc you will stay longer in hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Morbidity or disease risks of c section in general?

Increased risk in in subsequent PG?

A

Increase of infections, anesthesia risks, clots, bleeding, hypertensive disorders

Subsequent pg : uterine rupture, hemorrhage, previa, abruption, fetal demise, & neo RDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Main skin incision

A

Transverse or pfannenstiel - a bikini incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List of uterine incisions

A

Low transverse or kerr
Low vertical
Classic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why use the low transverse uterine incision?

blood loss
bladder
repair
subequent PG

A

You lose less blood bc of less skin
There’s moderate deflection of the bladder
Easier to repair but takes longer
Less rupture risk with subsequent PG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why wouldn’t you want to use low transverse?

How long
Size of baby
Extend
Stretch

A

Making the incision takes longer
Not good for large babies
Can extend into lateral blood vessels
Incision can stretch and become thin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why use low vertical uterine incision

A 
Good for multiple gestations
Good for abnormal fetal presentations
Placenta previa is ok
Non-reassuring fetal status option
Preterm infants
LGA infants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why wouldn’t you lost low vertical uterine incisions

A 
Due to incision extending into cervix
Can take time to get past bladder
Hemostasis and closure is more difficult
Higher risk of rupture in PG
And if you get this once, you'll have to get it again in all PG even if you technically could've done vaginal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the classic uterine incision

A

incision in the upper portion of uterus

  • we don’t use it much anymore due to blood loss and difficulty of repair
  • can rupture in next pgs
  • repeat CS require
  • NO TOLAC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is TOLAC?

what reduces success?

A

Trial of labor or being given the opportunity to deliver vaginally after already having a csection
- only offered w low transverse

obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Greatest risk of TOLAC?

other risks?

A

Uterine rupture so don’t use cervical ripening agents

iterine dehiscence
hysterectomy w tear needed
infections
death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Advantages of TOLAC

A

fewer infections
less blood loss
fewer transfusions
shorter hospital stay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

VBAC

A

vaginal birth after c section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Scheduled anesthesia for c sections

A

spinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Emergent anesthesia for c sections

A

Combined

General anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Preoperative care needing to be done before the c section?

How do they do this?

A

Validate the fetus maturity is 39 weeks

With a sonogram or amniocentesis to get L/S. PG levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What needs to be taken on admission for c section

A

All vitals including the baby’s FHR
Urinalysis. CBC, H&H
Blood and cross type
Accucheck glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does NPO status need to be?

A

8 hours or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Who is responsible for informed consent?

A

Doc but you are there to witness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why do we remove nail polish?

A

for 02 sat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What things do we need to remove before c section?

What needs to be put on the patient?

A

Dentures
Orthodontic devices
Contacts (you can wear glasses if you want)

Put the proper hospital ID on and have the baby’s ID ready

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Examples of anticipatory guidance you can give before procedure of c section

A

Deep breathing
Coughing
Turning
Leg exercises such as ankle rolls or leg lifts

26
Q

What type of needle do IV fluids need to be started with ?

A

large bore needle but do it in the non-dominant hand

27
Q

What do you do if the patient has any allergies before going into c section?

A

Clearly label it on the band they’re wearing

Notify anesthesia

28
Q

Meds that might be used to neutralize gastric activity?

A

Antacids like Bicitra, Alka seltzer Gold

29
Q

Drugs that decrease gastric secretions

A

Tagement or zantac

30
Q

Drug that increases gastric emptying

A

Reglan

31
Q

Why might we give antibiotics? Which route?

A

Given IV to prevent infection

32
Q

How will we transport the patient if schedule c section?

What if it is emergent?

A

Walking

On bed

33
Q

What needs to be used to drain the bladder before surgery?

A

Indwelling catheter that is placed after the block

- make sure to verify it drains by putting it below the bladder

34
Q

Can mom have a support person in the OR for c section if she is awake?

What do they wear?

A

Yes she can. They sit at the head of the bed

They need to wear gown and shoe covers

35
Q

How should the skin be prepped for c section? What do you do before this though?

A

Scrubbed and shaved

- make sure to rule out any allergies to iodine or prep

36
Q

What type of anesthesia is given in c sections

A

regional spinal

37
Q

How do they prevent vena cava syndrome and maternal hypotension during a c section?

Safety precautions for mom when it comes to the bed?

A

Tilt hips with wedge or table to 15 degrees from midline

Mom will be strapped down

38
Q

What is it called when they give the time for when the procedure begins

A

Time out

39
Q

When do they take the fetal monitoring systems off?

A

Will take FHR monitor off until right up to procedure

- internal and external

40
Q

What needs to be turned on to prevent heat loss once baby is born

A

bed warmer

41
Q

IV made that is always given after delivery of placenta

A

IV oxytocin to help uterus contract

42
Q

How long will mom be in a recovery room if she is stable?

A

2 hours

43
Q

Greatest concern for during recovery/postpartum

How to you check on this

A

Hemorrhage

Check funds, incision dressing , and lochia

44
Q

What do you need to do in post op about the foley

A

Just watch it. Take strict I & O and note the coloring

45
Q

When can mom do feeding

A

Once in recovery room if everyone is ok

46
Q

capnography

A

measures CO2

  • done in obese individuals a lot
  • if they have this, they will remain down in the recovery room
47
Q

When can mom do skin to skin

A

Can do it in recovery room

48
Q

What is put on mom post op to prevent clots

A

SCD’s

- but if mom is already ambulating, she doesn’t need them. take them off bc they are $$

49
Q

When can you transfer mom from her recovery room to the postpartum end?

What should you encourage as soon as mom is able to feel her legs?

A

When she is alert and orientated and feels her legs

Ambulation!
- it reduces clots & gas

50
Q

What does mom need to completely avoid in recovery/post partum end? Why?

A

Avoid rocking, ice, straws, cold beverages, and carbonated beverages
- to reduce gas

51
Q

What orders should you check before giving pain meds post partum?

A

Duramorph anesthesia PCA pump placement

52
Q

What will fundal checks feel like once anesthesia wears off

A

very very painful

53
Q

How long is the incision dressing left on?

A

24 hrs

54
Q

Standards needed before taking out an IV in post partum recovery

A

Vs stable and mom is drinking fluids
No n/v
No iv meds anymore
No temp

55
Q

If mom is having constipation post partum, what might be the cause

A

pain medications.

- offer stool softeners and aids

56
Q

Before mom can begin ambulating, what do you need to assess for

A

Assess how steady mom is and if she gets dizzy or anything

- check BP

57
Q

Common meds given before dismissal

A

Rh immune globulin
Rubella
Tetanus update
Influenza

58
Q

Can mom drive while on pain meds

A

no

59
Q

What is the heaviest thing mom can lift after c sectionbirth

A

Nothing heavier than the baby

60
Q

VERY important dismissal education that you need to talk about w mom

A

Neonate Jaundice
Percent of weight loss
If they stooled or not
Feeding patterns

61
Q

What do we need to screen mom for after delivery

A

post partum depression

62
Q

When does mom need to call doctor if she’s having probelms

A 
Temp of 100.4 and higher
Urinary complaints
Lochia regression
Incision redness and drainage
Abdominal pain

Clinical Exams (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions