NURSING CARE OF A FAMILY DURING A SURGICAL
INTERVENTION FOR BIRTH, A+ REVISION MATERIAL
WITH DIAGRAMS AND EXPLANATIONS
1. 2020 Goals: 1) Reduce the rate of C-section births amount low risk women having
their first child
2) Reduce rate of C-section among women having a prior C-section.
2. Amniotomy: artificial rupture of membranes; to increase labor
contractions and allow fetal head to contact the cervix.
-patient in dorsal recumbent
-amniohook or hemostat is passed vaginally
3. Epsiotomy: surgical incision of perineum to prevent tearing, release re,
shorten birth, women who have had femal circumcision.
Nsg:
-mediolateral incision have less risk of rectal tear
-midline incisions cause less blood loss
-No anesthesia needed
-suturing done after birth with minor anesthesia
4. Procedures for High-Risk Pregnancies: 1) Internal electronic monitoring
-most precise for FHR and contractions
-catheter passed into uterus
-FHR measured by electrode on scalp
2) scalp stimulation
-assessing acid/base in a fetus
-pressure applied to scalp and FHR variability is assessed
3) Fetal oxygen saturation level
-sensor placed by cheek
, 5. What does it mean if the baseline does not return to 20mmHg?
Uterine hypertonia
6. What does it mean if scalp stimulation does not cause FHR acceleration?
fetus is in distress and becoming acidotic. FHR variability is depressed.
7. C-section Intro: -often used as a prophylactic measure to address
complications such as CPD, breech, failure to progress -32% of women have C-
sections
-nurse midwifery have lower percentage of C-sections because of low-risk
women in these settings.
-explain that C-section is not a comparable option to vaginal birth, vaginal birth is
always preferable.
8. Selected Indications for C-section: 1) Maternal
factors
2) Placental factors
3) Fetal factors
9. Scheduled C-section: Done for reasons that are planned. Ample time to
know that it is indicated.
-position of the fetus indicates it (transverse, breech)
-infections transmission (HIV, herpes)
-preterm infant to avoid pressure on head
10. Emergent C-section: Done for reasons that are an emergency.
-placenta previa
-separation of placenta
-fetal distress
-failure to progress
2/10
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