Intrapartum and Postpartum Care of Cesarean Birth Families

Question 1

Common maternal indications for C/S

(5)

Answer 1

1. Previous C/S
2. Uterine surgery
3. Placental abnormalities (placenta previa)
4. Dystocia
5. Pre-existing or pregnancy related maternal health factors

Question 2

Common fetal indications for C/S

Answer 2

1. Malpresentation
2. Non-reassuring fetal heart rate
3. Multiple gestations

Question 3

What diagnostic tests are scheduled before c/s?

(2)

Answer 3

1. Complete Blood Count (CBC)
2. Type and Screen

CBC includes platelets.

Question 4

What is given before spinal or epidural anesthesia to decrease risk of hypotension?

Answer 4

IV fluid

usually 500 to 1000 mL

Question 5

When checking vital signs for c/s what may be increased and for what reason?

Answer 5

Blood pressure due to anxiety

Question 6

What can be done to increase maternal core temperature, improve neonatal umbilical arterial pH and Apgar scores for c/s births?

Answer 6

prewarmed IV fluids

Question 7

What prophylaxis are given prior to c/s delivery?
(2)

Answer 7

1. Narrow-specturm antibiotics
2. Venous thromboembolic

Question 8

What is the “decision to incision” rule

Answer 8

Hospitals should have the capability to respond to obstertric emergencies within 30 minutes.

Question 9

inadvertent injection of anesthetic agent into a maternals blood stream may cause what effects?

Answer 9

1. Ringing in the ears
2. Metallic taste
3. Hypotension

Question 10

Which anesthesia does not provide full sensory and motor block?

Answer 10

Epidural

Question 11

Which anesthesia is associated with feelings of tugging and pulling during the procedure

Answer 11

Epidural

Question 12

When is general anesthesia indicated?

(4)

Answer 12

1. Rapid delivery is imperative
2. severe hemorrhage
3. Seizures
4. Failed spinal placement

Question 13

What are the contraindications for epidural or spinal anesthesia (4)

Answer 13

1. Low platelet count
2. Infection (sepsis)
3. Hypovolemia (↓ blood volume)
4. Spine abnormalities

Question 14

What type of cut is the “classical” c/s cut

Answer 14

vertical

Question 15

What two times does the nurse record during a c/s?

Answer 15

1. Delivery of neonate
2. Delivery of placenta

Question 16

What blood related complication can occur with post-op c/s?

(3)

Answer 16

1. Hemorrhage
2. Anemia
3. Hematuria

Question 17

What are vital signs of hemorrhage?

Answer 17

1. Increase HR
2. Decrease BP

Question 18

What side effects (4) are monitored for intrathecal morphine?

analgesic in combination with local anesthetic in spinal anesthesia

Answer 18

1. Pruitus
2. Nausea/vomiting
3. Urinary retention
4. Respiratory depression

Question 19

What is added to IV fluids post-op c/s to decrease risk of hemorrhage?

Answer 19

Oxytocin

assists uterus w/ contracting

Question 20

Normal finding

How much should the patient void after urinary catheter removal post c/s within 2 to 3 hours?

Answer 20

200 to 300 mL

Question 21

What are intraoperative complications (4) associated with cesarean birth?

occurring or performed during the course of a surgical operation.

Answer 21

1. Bladder or bowel trauma
2. Maternal respiratory depression (R/T anesthesia)
3. Hemorrhage
4. Maternal hypotension