Is it possible?

[LynnCrawford]

Dumb question. I can't really think right now, but is it possible to labor during a c-section?

In my clinical assignment, I had a patient that was induced for labor (or induction of labor, however you say it). Well, after a day and a half, the patient only dilated 2 cm, so she had to undergo a c-section. I am also looking for confirmation or suggestions on this. The patient didn't have any complications.

Problems:

• The only thing was that the patient lost 800 ml of blood and her H&H decreased a bit below normal range, but not enough to consider her anemic I guess, the doc didn't even order an iron supplement or prenatal vitamin.
  
• The patient had tric but was not treated with anything for it (??).
  
• The patient had acute pain in her back during labor and pain at her incision site postpartum.
  

The patient doesn't want to breastfeed.m I can't think for the life of me of any risk factors or nursing diagnosis besides these:

• Risk for impaired comfort related to acute back pain.
  
  
• Risk for altered parent-infant attachment.
  

I don't understand how to come up with a nursing diagnosis for this patient when she is almost perfectly fine (??)

[klone, MSN, RN]

She is not almost perfectly fine. She just went through major surgery.

Risk for infection

Pain management

If she has trich, you should question psych-social stuff...how is her relationship with her partner? Is she going to have physical and emotional support postpartum?

If she's not going to breastfeed, what kind of issues might she have in that first week or two, as her body goes through lactogenesis II?

[klone, MSN, RN]

And I'm not really sure what you mean in the title of your thread and your initial question. It doesn't really make sense in the context of the rest of your post.

[ceebeejay]

She is a surgical patient with all of the risk factors that come with that. Just because c-sections are routine, doesn't mean they don't have risk. Where is her incision, what are the risk factors associated with it's position? Why are you looking for her to urinate? Why do you want her to have a bowel movement? Is the pain associated with her back or her incision. What meds have they given her post-partum? Why? She's not breastfeeding, what is she going to need to know about that? Think of all of things you want to see when you walk into her room and why want to see that, those are your possible risks.

[LynnCrawford]

It was actually two questions. The first was just a random question and the one below is the main question.

I thought about risk for infection but I just didn't have a lot of supporting data besides the fact she had a c-section. Her trich was never treated for some strange reason but I guess it didn't really affect the pregnancy.

I also went with risk for fatigue

I thought of risk for thrombophlebitis, because of the long labor she'd endured prior to c/s and being in pain postpartum.

[LynnCrawford]

I wish there was just one big nursing diagnosis that I can fit everything under. lol! Like pain, fatigue, breastfeeding incapability, risk for infection, thrombophlebitis, knowledge def (breastfeeding), etc.

[Katie71275]

STDs can and do affect the pregnancy. They can cause preterm labor and some can even kill your baby. Risk for infection and pain will be the 2 biggies that go with almost any surgery. All sorts of teaching can be done for the OB patient. Parenting a newborn, breastfeeding(or not), etc.

How many dx do you have to come up with? We did 3 while in nursing school. LIke I said, Pain and risk for infection should be your biggest ones. others could be related to urination, bm, mobility, or another biggie(why do we use incentive spirometers with our c-sections? That ones a good one too ).

[Esme12, ASN, BSN, RN]

are you doing a care plan?

[Daphne101503]

I'm not sure what you are asking. But, a patient can come in to be induce, and it doesn't happen in a timely matter that the OB says it not happening that way and decides to do a C-Section. He will state the diagnose as Failure to progress, non reassuring fetal heart rate, and many other "reasons" to get it over with.