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BSN-3 Group 2
NCM 102 RLE
General Objectives: At the end of my discussion, student nurses will be able to acquire knowledge, develop skills and gain positive
attitude in dealing with nursing care to patients with cesarean section secondary to cephalopelvic disproportion
Specific Objectives: At the end o 15 minutes class-discussion student nurses will be able to:
The second most common reason that a c-section is performed is difficult childbirth due to non-progressive labor (dystocia).
Difficult labor is commonly caused by one of the three following conditions:
• there are problems with the position of the baby, such as breech
Diagnostic Exam
• Ultrasound- testing reveals the positions of the baby and the placenta and may be used to estimate the baby's size and
gestational age.
• Fetal heart monitors, transmit any signals of fetal distress.
• Oxygen deprivation may be determined by checking the amniotic fluid for meconium (feces); a lack of oxygen may
cause an unborn baby to defecate. Oxygen deprivation may also be determined by testing the pH of a blood sample
taken from the baby's scalp; a pH of 7.25 or higher is normal, between 7.2 and 7.25 is suspicious, and below 7.2 is a
sign of trouble.
• Complete blood count (CBC),Blood typing (ABO) and Cross match
• Urinalysis-Determine albumin and Glucose levels
• X-ray pelvinetry – Determine CPD,flexion of head in breech position
• Amniocenteses-Assess fetal lung maturity
Medical Management
Antibiotics after cs
If there were signs of infection or the woman currently has fever, continue antibiotics until
the woman is fever-free for 48 hours.
Analgesia After Cesarean Section
• Adequate postoperative pain control is important. A woman who is in severe pain does not
recover well.
• Avoid over sedation as this will limit mobility, which is important during the postoperative
period.
• Women should be offered diamorphine (0.3–0.4 mg intrathecally) for intra- and
• postoperative analgesia because it reduces the need for supplemental analgesia after
• Adding acetaminophen also potentiates the effects of the other medications with very little
additional adverse risk
• analgesic rectal suppositories for relief of pain in women following caesarean section
• Ambulation enhances circulation, encourages deep breathing and stimulates return of normal
gastrointestinal function. Encourage foot and leg exercises and mobilize as soon as possible,
usually within 24 hours
Nursing Intervention
1.Perform preoperative care
• to ensure that the uterus remains contracted, that there is no excessive vaginal bleeding or bleeding at
the incision site,
• that there is adequate urine output,
• monitor routine vital signs (blood pressure, temperature, breathing).
• Pain medication is also given, initially through the IV line, and later with oral medications.
• When the effects of anesthesia have worn off, about four to eight hours after surgery, the woman is
transferred to a postpartum room
• When the woman is passing gas, begin giving her solid food.
• If the woman receives IV fluids for more than 48 hours, monitor electrolytes every 48 hours. Prolonged
infusion of IV fluids can alter electrolyte balance.
• Ensure the woman is eating a regular diet prior to discharge from hospital.
• Women who are recovering well and who do not have complications after CS can eat and drink when
they feel hungry or thirsty