Cesarean Birth - CesareanBirth

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Cesarean Birth Cesarean birth is an alternative to vaginal birth only when the safety of the mother and/or fetus is compromised. CLIENT ASSESSMENT DATA BASE Activity/Rest Fatigue may be present. Circulation Hypertension (escalating PIH) Hypotension, ashen color, cool/clammy skin (uterine rupture) Ego Integrity May view anticipated procedure as a sign of failure and/or as a negative reflection on abilities as a female May actually fear intervention/view surgery as life-threatening Irritable/emotional tension, (emotional response to prolonged labor; physiological response to PIH) Food/Fluid Excessive weight gain, nausea/vomiting, generalized edema (PIH) Pain/Discomfort Prolonged/dysfunctional contractile pattern (dystocia). Uterine tenderness may be present; severe abdominal pain (uterine rupture). Right upper quadrant (RUQ)/epigastric pain (PIH). Headache (PIH). Neurosensory Visual disturbance/scotomata (spots in visual field) (PIH) Seizure activity (eclampsia) Hyperreflexia, clonus (PIH) Safety Elevated temperature (infectious process/dehydration). Active STD (e.g., herpes). Severe Rh incompatibility. Prolapsed cord. Fetal distress. Impending delivery of premature fetus. Fetal macrosomia (estimated >4000 g). Unsuccessful external cephalic version to rotate breech presentation, or transverse lie. Membranes may have been ruptured for 24 hr or longer. Sexuality CPD; tumor/neoplasm obstructing the pelvis/birth canal Multiple pregnancies or gestations (overdistended uterus) Substantial vaginal bleeding (placenta previa/abruptio placentae) Previous cesarean delivery with classical incision; previous uterine or cervical surgery Teaching/Learning Presence of maternal complication/risk factors, such as severe PIH, diabetes, renal or cardiac disease, or ascending  infection; prenatal abdominal trauma; maternal age >35 yr.
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Procedure may or may not be planned, affecting client’s preparation and understanding of procedure. Failed induction. Maternal age. DIAGNOSTIC STUDIES Complete Blood Count (CBC), Blood Typing (ABO) and Cross-match, Coombs’ test:  Preoperative screening tests. Urinalysis:  Determines albumin/glucose levels. Cultures:  Identify presence of herpes simplex virus type II. X-ray Pelvimetry:  Determines CPD, flexion of head in breech position. Amniocentesis:  Assesses fetal lung maturity. Ultrasonography:  Locates placenta; determines fetal growth, lie, and presentation, as well as fetal  anomalies/malformations favoring cesarean delivery.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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Cesarean Birth - CesareanBirth

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