Hi all, I am a 2nd semester RN student and new to this forum.
I am trying to fill out a Mother Baby preparation worksheet for my instructor and have a two part question that I can not find in the book, I hope you can help.
Explain the technique you will use to assess the fundus of a client who has had a c-section delivery with a low transverse incision
and then with a midline
Deepest gratitude to any help.
Apr 1, '09
Fundal checks for c/s moms are the same as vaginal delivered pts except: support the uterus (at the incision) with one hand and massage the fundus with the other. During the recovery period, the patient should still have good pain control but once that has worn off, the discomfort is more obvious. Be gentle but be thorough, you don't want to have a boggy uterus and bleeding. Explain how and why you are doing the checks. I also have the mom touch the uterus and tell her she can also do fundal massage. Once they do that, they become more comfortable with the checks.
Apr 5, '09
The only difference I can think of with a midline incision is that she probably had general anesthesia (midlines are typically done when there's a real rush and no time for a spinal) and so will be more uncomfortable. Gentle but firm, it hurts but is important. Also, with a midline incision, the umbilicus is covered by the dressing, so you may have to estimate the fundal heigth in relation to it. I suppose you could mark the level on the dressing. The important part is that the fundus is firm, not rising significantly, and that there is not blood gushing when you apply pressure.