ob chapter 24 Flashcards
What is a cesarean birth?
Birth accomplished through an abdominal incision into the uterus. It is slightly more hazardous than vaginal birth but one of the safest surgical procedures.
What is an amniotomy?
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.
How is an amniotomy performed?
The pregnant patient assumes a dorsal recumbent position, and an amniohook is passed vaginally to tear the membranes, allowing amniotic fluid to escape.
What is an episiotomy?
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.
What is a major risk of amniotomy?
It puts the fetus at risk for cord prolapse if a loop of the cord escapes into the vagina with the fluid.
When should an amniotomy be performed?
Only if the fetal head is well applied to the cervix to reduce the risk of cord prolapse.
What should be done immediately after an amniotomy?
Measure the fetal heart rate (FHR) to confirm that a cord prolapse has not occurred.
What is internal electronic monitoring?
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.
What is scalp stimulation used for during labor?
To assess fetal well-being if FHR variability appears depressed.
How is scalp stimulation performed?
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.
What does it indicate if there is no fetal heart rate acceleration with scalp stimulation?
The fetus may be in distress.
What is the body’s stress response to surgery?
The body releases epinephrine and norepinephrine to preserve major system functions.
What are the effects of epinephrine during surgery?
Increases heart rate (HR), causes bronchial dilation, raises blood glucose, leads to peripheral vasoconstriction, and increases blood pressure (BP).
How does surgery interfere with body defenses?
Incising the skin removes the body’s primary defense against bacterial invasion.
How much blood loss can occur during surgery?
500 to 1,000 mL.
What body organ functions may be temporarily disrupted by surgery?
Uterine, bladder, intestinal, and lower extremity circulatory function.
How does surgery affect self-image/self-esteem?
Surgery leaves an incisional scar that may cause self-consciousness.
What is a major concern for the uterus after cesarean birth?
The uterus may not contract well, leading to postpartum hemorrhage.
How is the bladder affected during cesarean birth?
The bladder must be displaced anteriorly, which may result in reduced sensation of filling after surgery.
How can intestinal function be affected by surgery?
Pressure during surgery can lead to paralytic ileus, causing halted intestinal function and obstruction.
How is lower extremity circulation affected by surgery?
Impaired blood flow can lead to thrombophlebitis (blood clot formation in a vein).
Why are deep breathing exercises important postoperatively?
They fully aerate the lungs and help prevent mucus stasis, reducing the risk of lung infections like pneumonia.
How often should deep breathing exercises be performed?
5 to 10 deep breaths every hour.
How is a deep breathing exercise performed?
The patient inhales deeply, holds the breath for 1-2 seconds, then exhales deeply.
