Cesarean Birth Care Plan

[tsprink72]

I have to do a care plan for a patient who had a c-section for failure to progress. She had no pain. She was hispanic and her husband had to translate for her. She had not had a bowel movement in 3 days. I know that Impaired tissue integrity would be one of my nursing dx. I think that the language barrier would be one and the bowel movement but I'm not sure. Can anyone help? Our teacher expects every nursing dx, not just the most important. Any help would be appreciated.

[Irishlass79]

It is hard to judge without more info such as labs etc. But I would think about priority. What are the number one priorities for a patient that just had a major surgery? What would you be most concerned about if you had a big insision on your abdomen.

On a seperate note you have to think why is she not having a bowel movement? Is is fear of bursting open if she bears down? Is she up and walking? Nutrition before the c section? Fluids?

Is there a risk for bleeding or infection? What was her fundus like? Boggy? Appropriate for how many days post op she is? What does the incision site look like (red, warm, drainage well approximated)? Her lady partsl bleeding describe?

What was she like about the incision? Is she coping with the altered body image and unexpected event?

Is she ready to learn about how to care for herself? There is a lot of post op teaching involved here.

[JROregon, ASN, BSN, RN]

3 days post op, she's probably doing fine on oral pain meds. I think the lack of bowel movement after 3 days of abdominal surgery is pretty common. The above poster is right. The skin integrity at the incision site, bleeding, the uterus shrinking back to normal size. The lack of BM would be on the list, but it's not life-threatening at 3 days post op like an infection or uncontrolled bleeding would be.