ob chapter 24

Question 1

What is a cesarean birth?

Answer 1

Birth accomplished through an abdominal incision into the uterus. It is slightly more hazardous than vaginal birth but one of the safest surgical procedures.

Question 2

What is an amniotomy?

Answer 2

The artificial rupturing of membranes during labor to allow the fetal head to contact the cervix more directly, increasing contraction efficiency and speeding up labor.

Question 3

How is an amniotomy performed?

Answer 3

The pregnant patient assumes a dorsal recumbent position, and an amniohook is passed vaginally to tear the membranes, allowing amniotic fluid to escape.

Question 4

What is an episiotomy?

Answer 4

A surgical incision of the perineum made to release pressure on the fetal head and possibly shorten the last portion of the second stage of labor.

Question 5

What is a major risk of amniotomy?

Answer 5

It puts the fetus at risk for cord prolapse if a loop of the cord escapes into the vagina with the fluid.

Question 6

When should an amniotomy be performed?

Answer 6

Only if the fetal head is well applied to the cervix to reduce the risk of cord prolapse.

Question 7

What should be done immediately after an amniotomy?

Answer 7

Measure the fetal heart rate (FHR) to confirm that a cord prolapse has not occurred.

Question 8

What is internal electronic monitoring?

Answer 8

The most precise method for assessing fetal heart rate (FHR) and uterine contractions by passing a pressure-sensing catheter through the vagina into the uterus after membrane rupture.

Question 9

What is scalp stimulation used for during labor?

Answer 9

To assess fetal well-being if FHR variability appears depressed.

Question 10

How is scalp stimulation performed?

Answer 10

By applying pressure with fingers to the fetal scalp through the dilated cervix, causing a tactile response that momentarily increases FHR if the fetus is not in distress.

Question 11

What does it indicate if there is no fetal heart rate acceleration with scalp stimulation?

Answer 11

The fetus may be in distress.

Question 12

What is the body’s stress response to surgery?

Answer 12

The body releases epinephrine and norepinephrine to preserve major system functions.

Question 13

What are the effects of epinephrine during surgery?

Answer 13

Increases heart rate (HR), causes bronchial dilation, raises blood glucose, leads to peripheral vasoconstriction, and increases blood pressure (BP).

Question 14

How does surgery interfere with body defenses?

Answer 14

Incising the skin removes the body’s primary defense against bacterial invasion.

Question 15

How much blood loss can occur during surgery?

Answer 15

500 to 1,000 mL.

Question 16

What body organ functions may be temporarily disrupted by surgery?

Answer 16

Uterine, bladder, intestinal, and lower extremity circulatory function.

Question 17

How does surgery affect self-image/self-esteem?

Answer 17

Surgery leaves an incisional scar that may cause self-consciousness.

Question 18

What is a major concern for the uterus after cesarean birth?

Answer 18

The uterus may not contract well, leading to postpartum hemorrhage.

Question 19

How is the bladder affected during cesarean birth?

Answer 19

The bladder must be displaced anteriorly, which may result in reduced sensation of filling after surgery.

Question 20

How can intestinal function be affected by surgery?

Answer 20

Pressure during surgery can lead to paralytic ileus, causing halted intestinal function and obstruction.

Question 21

How is lower extremity circulation affected by surgery?

Answer 21

Impaired blood flow can lead to thrombophlebitis (blood clot formation in a vein).

Question 22

Why are deep breathing exercises important postoperatively?

Answer 22

They fully aerate the lungs and help prevent mucus stasis, reducing the risk of lung infections like pneumonia.

Question 23

How often should deep breathing exercises be performed?

Answer 23

5 to 10 deep breaths every hour.

Question 24

How is a deep breathing exercise performed?

Answer 24

The patient inhales deeply, holds the breath for 1-2 seconds, then exhales deeply.

Question 25

What is the purpose of incentive spirometry?

Answer 25

To encourage deep breathing and fully aerate lung spaces, preventing respiratory complications.

Question 26

How does an incentive spirometer work?

Answer 26

The patient inhales deeply, causing a small ball to rise in a narrow tube, indicating lung expansion.

Question 27

How often should an incentive spirometer be used postoperatively?

Answer 27

Three to four times a day.

Question 28

Why is turning important postoperatively?

Answer 28

It helps prevent respiratory and circulatory stasis.

Question 29

What is the most effective way to stimulate lower extremity circulation after a cesarean birth?

Answer 29

Early ambulation.

Question 30

What should be emphasized in postpartum discharge planning after a cesarean birth?

Answer 30

The need for adequate help with the newborn and household responsibilities due to pain and discomfort.

Question 31

What are common activity restrictions after a cesarean birth?

Answer 31

Do not lift objects heavier than 10 lbs or walk upstairs more than once a day for the first 2 weeks.

Question 32

What are signs of complications that should be reported to the primary care provider after a cesarean birth?

Answer 32

Redness or drainage at the incision line, lochia heavier than a normal menstrual period, abdominal pain (beyond suture line discomfort), and a temperature > 38°C (100.4°F).

Question 33

When can a patient resume sexual activity after a cesarean birth?

Answer 33

As soon as the act is comfortable.