Operative Deliveries

Question 1

Types of Operative Deliveries (2)

Answer 1

C Section

Episiotomy

Question 2

Episitiomy

Answer 2

surgical incision of perinuem to enlarge the area for a safer delivery

Question 3

C section

Answer 3

surgical incision through skin and uterus to remove . a fetus

Question 4

Types of C Sections (2)

Answer 4

planned, vs emergency

Question 5

Goal of Episiotomy

Answer 5

minimize the laceration of perineum and over stretching

small cuts may heal naturally, or else then needs sutures

Question 6

Episiotomy Indications

Answer 6

prevent damage to perineum from laceration
prevent jagged scars
**there is ALWAYS risk of an infection

Question 7

Complications with an Episiotomy

Answer 7

blood loss
infection**
pain**

Question 8

Ways to Avoid an Episiotomy (4)

Answer 8

proper breathing techniques
avoid lithotomy position
kegel exercises
warm compresses

Question 9

Nursing Care of Episiotomy

Answer 9

offer support and comfort 
maintain the sterile area
document the episiotomy
FIRST, ice the area
after 24 hrs, warm comrpesses

Question 10

Purpose of C Seciton

Answer 10

preserve the life or health of mom/and or fetus

Question 11

Types of C Sections

Answer 11

veritcal skin + uterus
horizontal skin, vertical uterus
**horizontal skin and uterus is favorable. can then have VBAC

Question 12

Indications for a C Section

Answer 12

prolpased umbilical cord
maternal diabetes
abrption of the placenta

Question 13

Pelvic Types, and what is favorable

Answer 13

Adequate: gynecoid, anthropoid

Bad: android, platypelloid

Question 14

morality in births

Answer 14

vaginal birth rates are higher

Question 15

C Section complications

Answer 15

woud infections
wound dehiscence
hemorrhage
injuries to bowel and bladder

Question 16

PreOP C Section

Answer 16

remove dentures, glassess, etc
start IV
straight cath

Question 17

PostOP C Section

Answer 17

ASSESS abdominal, drainage, IV, etc
assess for post op bleeds
encourage skin to skin and breast feeding

Question 18

BUBBBLE

Answer 18

Breasts
Uterus
Bladder
Bowel
Lochia
Incision
Episiotomy

Question 19

Blood Loss Estimates in both types of delveries

Answer 19

vaginal: 500 mL

C Section: 1000 mL

Question 20

Systemic Analgesia

Answer 20

crosses the blood brain barrier to provide central analgesia

Question 21

Medications given for pain in labor/delivery

Answer 21

benzos (valium, versed, ativan)

phenergan and Vistaril

Question 22

nerve block analgesia

Answer 22

local injection of xylocaine or marcaine
injected into perineal tissue or pudenal nerve block

perineal: for episiotomy
pudenal: relieve pain in 2nd stage of labor

Question 23

C Section Anesthesia

Answer 23

spinal or epidural: local

general: usually not choice option

Question 24

Spinal Anesthesia

Answer 24

epidural block
meds: lidocaine and fentanyl
injected at 4-5 lumbar space

Question 25

Nursing responsibility epidural

Answer 25

Pre: assess IV during: set up epidural post: assess for HTN, fetal HR, loss of sensation in limbs

Question 26

Complications of Epidural

Answer 26

``` Bradycardia "wet tap" spinal headache abscess epidural hematoma Hypotension ```

Question 27

Post Epidural Considerations

Answer 27

tylenol for pain may have decrease urine output assess for hypotension

Question 28

General Anesthesia considerations

Answer 28

roll under patient hip to relive aorta and vena cava

Question 29

VBAC

Answer 29

vaginal birth after C Section, | should be horizontal and horizontal