HELP, Instructor wants Patho on Care Plan for PP patient.

penaheather · Feb 9, 2012

I dont know if this will help, but why did she have a svheduled csection. It seems that something must have been going on in her body to lead to her having it done. :confused:

chellevonne · Feb 9, 2012

Thanks, unfortunately she had a scheduled c section, mainly because she had a previous c section. :-( So her body didn't even experience labor. :-(

heatheryk · Feb 9, 2012

could you use information regarding the uterus shrinking, pp bleeding, risk for hemorrhage (why?), or how about the hormone changes after delivery and hormones that trigger breast milk production ??

chellevonne · Feb 9, 2012

That sounds interesting. Maybe so.....Thanks!

ADN2B · Feb 9, 2012

Risk for infection from surgical incision.

chellevonne · Feb 9, 2012

Yes, I have Acute pain and Risk for infection as my diagnosis. All that is left to do is the pathology.

chellevonne · Feb 9, 2012

How does this sound?

surgical removal of the fetus, placenta, and membranes through an incision in the portion of the uterus just above the cervix after which the uterus should continue to harden therefore tightening around the blood vessels that fed the placenta. The pituitary gland is enlarged during pregnancy producing oxytocin that stimulates uterine muscle and lactation.

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lrobinson5 · Feb 9, 2012

You want to go through all of the changes that the body goes through. Think about many systems, not just reproductive. Cardiovascular, what is normal for women at this time? What about the bladder and it's possible effect on uterine involution (This also has to do with fluid on board)? What about the types of lochia? Return of ovulation?

There isn't a disease process, so you need to discuss the normal changes that happen in the postpartum patient.

chellevonne · Feb 9, 2012

THANKS!

morte, LPN, LVN · Feb 9, 2012

It would seem to me the patho behind this C section is either the same as the last one, or simply that she has already had one, there by compromising the uterine wall and potentially making labor dangerous?????

Esme12, ASN, BSN, RN · Feb 9, 2012

Is this what she is looking for? I found this.....

The Cesarean section is one of the most commonly performed surgical procedures in the United States. Also known as a C-section, this procedure is used to deliver a baby from the womb. C-sections can be planned, scheduled, or as an emergency procedure. Rarely, a physician will approve and perform the procedure upon the request of the mother, but this is not a recommended method of delivery if Read more.... it is not medically necessary.

It is a surgical procedure which requires partial or complete anesthesia, and it involves exposure of both mother and baby to complications which can range from moderate to severe. Some circumstances under which the surgery is performed are; a prolonged or extended period of hard' labor (the pushing stage) in which the mother makes no progress in delivering; drop in fetal heart rate; the pelvic structure may not be adequate to deliver the head, abruption of the placenta, etc.

Once the need for the surgery is confirmed, the patient is given a spinal epidural, which will numb the mother from the waist down. Once she is numbed, she is draped and prepped in the operating room. A three to five inch incision is made below the naval, right above the pelvic bone. The doctor then uses a cauterizing device to cut through the abdominal fat and muscle layers. Once done, spreaders will be placed, and the doctor commences to make another incision, this time into the uterus. Suction is used to remove amniotic fluid, and the doctor will then reach in to grasp the infant. The baby is then gently removed and the umbilical cord cut. The baby is now born.

Pathophysiology of Cesarean Section | Reference.com Answers

After the delivery, the doctor will suture first the uterus, and then the abdomen. Stitches, tape, staples or glue may be used. The recovery period is usually about six weeks. Physical activity should be limited at first, and gradually increased as tolerated. It can be a painful recovery due to the cutting of muscles, nerve and skin.

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Most of the physiologic changes occurring during a cesarean delivery are secondary to the physiologic adaptations to pregnancy, the medical or obstetrical complication affecting the mother, or secondary to obstetrical complications directly related to the pregnancy (eg, preeclampsia). The method of anesthesia used to perform the procedure also influences the physiologic adaptations that the mother undergoes during the procedure.

Before beginning the operation, inform the nursery so that a member of the nursery staff can be present to evaluate the baby after delivery and resuscitate as necessary.

[h=3]Laparotomy[/h]One option for entering the peritoneal cavity is to use a midline infraumbilical incision. This incision provides quicker access to the uterus. In pregnancy, entry is commonly enhanced by diastasis of the rectus muscles. This incision is associated with less blood loss, easier examination of the upper abdomen, and easy extension cephalad around the umbilicus.

I hope these help