Post emergency C-Section information needed

Specialties Ob/Gyn

Published

Following a c-section why would the patient lie in a supine position? Also, what is the procedure for administering Rho Gam? Lastly, what does it mean if the fundus is found to be above the umbilicus and deflected to the right of the abd? What would the initial nurisng intervention be?

I am working on a packet but we have not covered all of this information and I have been unable to find understandable and useful information online. Any direction would be greatly appreciated.

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I have to say, if you are a student, you should be able to find all these answers in your OB nursing text. I still have mine, and all this is in there. GOOD LUCK!

Up Vote Up Vote ×

Not quite sure about the supine, as we usually have the pt in a low fowler's position in recovery. Rhogam is usually given to negative mom's on the postpartum floor. and a uterus deviated usually means a distended bladder and they need to pee. bladder distention incr risk for bleeding as the uterus is not able to contract with a full bladder..

Up Vote Up Vote ×

I have searched the text I was given for OB however there is much not in there. I know why Rho Gam is given I just do not know the procedure ( I get the IM but the question asks for the specific procedure I just wonder if there is something special about the way it is injected or something)

Up Vote Up Vote ×

As for the deviated uterus, it's because of a full bladder. A Foley is usually placed prior to a c-section so if one is present check to see if it's dislodged. If one wasn't placed due to it being an emergency, then either straight cath or place a Foley depending on the unit policy.

Up Vote Up Vote ×

As a person who is Rh-, I paid special attention to the Rho Gam shots when I had my kids. The baby's blood was tested before I was given the second shot. No sense getting a shot that wasn't necessary! Like others have said, it is likely all in your textbooks.

Up Vote Up Vote ×
Specializes in L&D.

Your questions are somewhat confusing as I do not see how they are related to "post emergency c-section information". And what kind of packet are you referring to? Something to help educate patients or a packet that you as a student need to present or find answers for? Sometimes the phrasing of your questions makes all the difference in the answers you get.

Up Vote Up Vote ×
Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

After C/S (doesn't matter if it's planned or emergent) we generally keep pts in low fowlers. Supine would be if there was a spinal headache (which probably wouldn't happen with a crash c/s, as she would likely have general).

The procedure for administering Rhogam is just like that for any other IM injection.

Let me ask you a question - do you know why a fundus might be deviated to the right? Another poster answered already - it happens if the bladder is full. If the pt has a foley (which she would right after a C/S) and the fundus is deviated to the right, what do *you* think your nursing intervention would be?

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Another reason to keep patient in LF: Keeps blood pressures stable after regional anesthesia...

Up Vote Up Vote ×
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

AND if the uterus is deviated,I agree, you need to know why and what the proper intervention would be like Klone said.

There are several that come to my mind...

Up Vote Up Vote ×
Specializes in Home Health, Nursing Education.

Your questions are based on extremely BASIC ob nursing. Any OB nursing book at your local library will have the answer, if-as you say- your current book does not... which is a little strange in itself.

Critiacal thinking is more than processing or memorizing information. It makes sense after you understand everything's connections.

Being a student is hard work- for a reason- being a nurse is even harder... you do not have time to look things up for your "packets". The Case histories are there to teach you how to pull information together as a means of looking at the scenario as a whole- and they are also relatively common issues that are basic nursing issues for patients.

You will get there... but you have to find the information on your own before you will make any progress. Any information you get here will be just that-information. However, with the way you are posing your questions, I cannot see you getting the big picture... Critical thinking is YOU making your own connections when comparing multiple facts. It is not regurgitation.

I can tell you really want to learn, and that is great! :up:

Up Vote Up Vote ×
Specializes in L&D.

Before giving RhoGam, the cord blood is tested for the baby's type. If baby is Rh negative, it's not needed. If baby is Rh positive, Mom's blood is tested for presence of fetal Hgb and for antibodies. If mom has no antibodies, RhoGam will be given. Depending on the amount of fetal Hgb (do you know the difference between adult and fetal Hgb?, look it up) one or more amps of RhoGam may be given. You would do the usual patient identification process you do before giving any medication. You will also make a note of the Lot # and expiration date of the RhoGam and fill out a card for the mother to carry with her in her wallet. Can you figure out why that is done?

Up Vote Up Vote ×
+ Add a Comment