Chapter 24 Flashcards
Accomplished through an abdominal incision into the uterus
Cesarean Birth
Is the artificial rupturing of membranes during labor
Amniotomy
Is a surgical incision of the perineum
Episiotomy
What is the advantage of mediolateral episiotomy over midline episiotomy?
Decreasing chance of rectal mucosal tear
Surgical opening of the labia
Defibulation
Is the most precise method for assessing FHR and uterine contractions.
Internal Electronic Monitoring
It is most often used to assess whether contractions are strong enough to cause cervical change in the case of a prolonged labor course.
Internal Electronic Monitoring
It is inserted into the uterine cavity and alongside the fetus
Internal Electronic Monitoring
What can be evaluated in the Internal Electronic Monitoring
Frequency, duration, baseline strength, and peak strength of contractions
This is done by applying pressure with the fingers to the fetal scalp through the dilated cervix.
Scalp stimulation
This causes a tactile response in the fetus that momentarily increases the FHR
Scalp stimulation
Is an assessment of acid-base balance in a fetus in labor
Scalp stimulation
Cesarean Birth is used most often as a prophylactic measure to alleviate problems of birth such as:
*Cephalopelvic disproportion
*breech or multiple fetus births
*failure to progress in labor
Are planned and there is time for thorough preparation for the experience throughout the antepartal period.
Scheduled Cesarean Birth
Scheduled cesarean births are ideally done at
39 weeks or after full fetal development has occured.
Reasons for scheduled cesarean births are when there is a physical indication such as
Transverse presentation, infection that could be contracted by the fetus, or cephalopelvic disproportion
Births that are done for reasons that arise suddenly in labor
Emergent cesarean birth
Reasons for emergent cesarean birth:
*placenta previa
*premature separation of the placenta
*fetal distress
*failure to progress
Increases the heart rate, causes bronchial dilatatio, and elevates blood glucose level.
Epinephrine
The _____ serves as the primary line of defense against bacterial invasion
Skin
To ensure protection against postsurgical endometritis, medications are given such as
Prophylactic antibiotic, Ampicillin (omnipen)
Cephalosporin such as cefazolin (ancef)
During a vaginal birth, a patient loses how much blood
300 to 500 mL of blood.
Loss of blood increases how much with a cesarean birth
500 to 1000 mL
Effects of surgery on a pregnant patient:
*stress response
*interference with body defenses
*interference with circulatory function
*interference with body organ function
*interference with self-image or self-esteem
For preoperative interview, include questions like
*what the procedure will entail
*length of hospitalization anticipated
If they’ve been told about any postsurgical equipment to be used
*any special precautions that are being planned for the infant
Opening or rupture of the incision
Dehiscence
Operative risk for a pregnant patient
*poor nutritional status
*age variations
*altered general health status
*fluid and electrolyte imbalance
*fear
Common device used three to four times a day postoperatively to encourage deep breathing
Incentive spirometer
Gastric emptying agent
Metoclopramide (reglan)
Speed up stomach emptying or a histamine blocker
Ranitidine (zantac)
Acts to neutralize acid stomach secretions
Citric acid and sodium citrate (bicitra)
Preoperative diagnostic procedures:
*vital sign determination
*urinalysis
*complete blood count
*coagulation profile
*serum electrolytes and pH
*blood typing and cross-matching
Immediate preoperative care measures:
*Informed consent
*overall hygiene
*baseline intake and output determinations
*hydration
*preoperative medication
*patient chart and presurgery checklist
Is a form of morphine commonly used in addition to a local anesthesia in epidurals
Duramorph
The effects of duramorph lasts for
24 hours
What should be done after administering duramorph
Assess respirations every 2 hours postsurgery
Surgical site infections at the lower abdomen decreases with the use of
Chlorhexidine wipes
Incision is made vertically through both the abdominal skin and the uterus
Classic cesarean section
