Chapter 11 Flashcards
1
Q
what are indications for a c-section?
A
- hx of previous c/s
- arrest of labor in stage 1 or 2
- placental or uterine abnormalities
- cephalopelvic disproportion
- maternal risk factors
- fetal malpresentation
- Cat 3 FHR patterns (tachysystole)
- maternal exhaustion
- maternal fear
- epidural too early
2
Q
how can you prevent a c-section?
A
- induce for medical, not elective reasons
-use Bishop score when considering elective IOL - allow second stage to proceed without precipitous intervention
- consider vacuum- or forceps-assisted birth
- unneeded costs and risks (c/s costs more than vaginal birth; think long-term impacts)
3
Q
c-sections are classified as
A
- scheduled: breech position
- non-urgent: should get baby out soon
- urgent: need to get baby out sooner rather than later
- emergent: need to get baby out know
4
Q
perioperative care for a c-section consists of
A
- patient teaching
- diagnostic lab tests
- surgical care: catheter, NPO status
- antibiotics and VTE prophylaxis
- anesthesia manangement
- care for an unscheduled c/s
- consider PPH risk and need for type-specific blood on hold
5
Q
intraoperative care for a c-section includes
A
- nurse monitoring VS
- surgery complications
- documentation
- emotional support for mother and family
6
Q
postoperative care for a c-section includes
A
- recovery in a surgical suite
-2 hours if stable - nursing actions and monitoring
- first 24 hours: medical needs, bonding
- second 24 hours: discharge planing
7
Q
maternal-newborn bonding includes
A
- skin-to-skin contact
- positional considerations to avoid SUNC
- emotional support
- patient teaching
8
Q
what is SUNC?
A
sudden unexpected newborn collapse
- respiratory and cardiac collapse
9
Q
full recovery from a c-section takes approximately how long?
A
6 weeks or more
10
Q
what are some complications from a c-section?
A
- DVT
- paralytic ileus
- maternal hemorrhage
- bladder or incisional infections
11
Q
infection rate is higher for what classification of c-section?
A
emergent
12
Q
nursing actions in preparation for discharge after a c-section includes
A
- monitor incision for dehiscence and swelling
- assess fundus and lochia
- manage pain
- discontinue IVs and foley catheter
- monitor for VTE
- remove staples before discharge (*sutures and glue closer stays in place)
- instruct family that woman will need assistance
- facilitate bonding
13
Q
clinical pathways of a c-section
A
- assessments
- activity level (get out of bed, move around, stretching the incision will make them feel better, no heavy lifting)
- education (what is normal, what is not; to mom and family/partner)
- elimination (want gas)
- emotional needs
- medication (as needed)
- nutrition (variety of food, lots of water)
- pain management (meds, non-pharm measures)
14
Q
arrest of labor is defined as
A
- dilation of >/= 6 cm with ROM, contracting for > 4 hours
OR - > /= 6 hours of inadequate contractions with no cervical change
15
Q
arrest of labor during stage 2 is defined as
A
- with drugs: lack of continuing progress for 3 hours
- without drugs: lack of continuing progress for 2 hours
