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Nursing Care Plan for Cesarean Section (C-section)

A Cesarean section (C-section) is surgery to deliver a baby. The baby is taken out through the mother's abdomen. In the United States, about one in four women have their babies this way. Most C-sections are done when unexpected problems happen during delivery. These include
  • Health problems in the mother
  • The position of the baby
  • Not enough room for the baby to go through the vagina
  • Signs of distress in the baby
C-sections are also more common among women carrying more than one baby.

The surgery is relatively safe for mother and baby. Still, it is major surgery and carries risks. It also takes longer to recover from a C-section than from vaginal birth. After healing, the incision may leave a weak spot in the wall of the uterus. This could cause problems with an attempted vaginal birth later. However, more than half of women who have a C-section can give vaginal birth later.

Nursing Assessment for Cesarean Section

Assessment is the systematic process of gathering, verification, and communication of client data (Potter & Perry, 2005).

The assessment results are found on the client by cesarean section on nursing care plan maternal / infant (Doenges & Moorhouse, 2001) namely:
  1. Assessment of client data base
    Review the record of prenatal and intraoperative and indications for cesarean birth.

  2. Circulation
    Blood loss during surgical procedures of approximately 600-800 ml.

  3. Ego integrity
    Can show emotional labilitas of excitement to fear, anger or withdrawn. Client / partner may have questions or wrongly accept a role in the birth experience. Perhaps expressing inability to deal with new situations.

  4. Elimination
    Urinary catheter may be inserted, clear urine and pale bowel sounds absent, vague or unclear.

  5. Food / fluid
    Abdomen soft with no distension at baseline.

  6. Neoro sensory
    Damage to the movement and sensation below the level of spinal epidural anesthesia.

  7. Pain
    Discomfort may complain of a variety of sources such as surgical trauma, incision and accompanying pain, distended bladder-abdominal, the effects of anesthesia. The mouth may be dry.

  8. Respiratory
    The sound is clear and vesicular lung.

  9. Security
    Abdominal bandage may seem a little stain or dry and intact. Line parenteral, when used patent-free and hand erythema, swelling and tenderness.

  10. Sexuality
    Fundus contractions stronger and located at the umbilicus. Lochea is free flow and excessive clot / lot.

  11. Diagnostic tests
    Complete blood count, hemoglobin / hematocrit (Hb / Ht): assessing the change from preoperative levels and evaluate the effects of blood loss in surgery. Urinalysis: urine culture, blood, vaginal, and lochea.

Nursing Diagnosis for Cesarean section (C-section)
1. Acute pain related to postoperative wound

2. Risk for infection related to invasive procedures, skin damage, decrease in Hb

3. Risk for injury (mother) related to tissue trauma

4. Risk for impaired gas exchange (the fetus)

5. Deficient Knowledge : up to surgery

6. Anxiety

Nursing Diagnosis and Nursing Intervention for Cesarean Section Postoperative
Nursing Diagnosis

Risk for infection

Related to :
  • bleeding,
  • postoperative wound

Goal :
There were no infections, bleeding and wounds, after surgery.

Nursing Intervention for Cesarean Section Postoperative
  1. Assess the condition of output / dischart out; number, color, and odor from the operation wound.
    R / recording the changes in output. The existence of a darker color with a bad smell may be a sign of infection.

  2. Tell the client the importance of wound care during the postoperative period.
    R / Infection can arise from lack of cleanliness of the wound.

  3. Have a general culture in the output.
    R / Various bacteria can be identified through the output.

  4. Perform wound care.
    R / Incubation germs in the wound area can cause infection.

  5. Tell the client how to identify signs of infection.
    R / Various clinical manifestations can be nonspecific sign of infection, fever and increased pain may be symptoms of infection.

Nursing Diagnosis

Acute Pain

Related to
  • postoperative wound
Goal :
Pain is reduced / no pain

Nursing Intervention for Cesarean Section Postoperative
  1. Assess the condition of pain experienced by the client.
    R / Measurement of the level of pain can be performed with pain scales.

  2. Tell the client suffered pain and its causes.
    R / Improving coping clients, in dealing with pain.

  3. Teach relaxation techniques.
    R / Reduced perception of pain.

  4. Collaboration of analgesics.
    R / Reduced pain can be done by giving oral or systemic analgesics, in a broad spectrum / specific.
READ MORE - Nursing Care Plan for Cesarean Section (C-section)

List of Pulmonary Tuberculosis Nursing Diagnosis NANDA

Pulmonary tuberculosis (TB) is a highly contagious disease caused by a bacteria known as Mycobacterium tuberculosis. TB generally affects the lungs, but it also can invade other organs of the body, like the brain, kidneys and lymphatic system.

TB is spread through coughing, sneezing, and spitting. Only a small amount of inhaled germs are needed to become infected, however prolonged exposure to someone else who has TB is the easiest way to get the disease. Those who have a weakened immune system are even more at risk.

Many people who are infected with TB have few or no symptoms at all, at least in the beginning. Some people develop symptoms slowly, over time, and pay little attention to them until the disease has reached the advanced stages. When symptoms do appear, they generally include:
  • fatigue
  • loss of appetite and weight loss
  • cough with purulent and/or bloody sputum
  • night sweats
  • low-grade fever that occurs mostly in the afternoon
  • lethargy

a. Ineffective airway clearance

related to viscous secretions or blood secretions, weakness, poor cough effort, edema, tracheal / pharyngeal.

b. Impaired Gas Exchange

related to the reduced effectiveness of the surface of the lung, atelectasis, alveolar capillary membrane damage, thick secretions, bronchial edema.

c. Imbalanced Nutrition: Less Than Body Requirements

related to fatigue, frequent coughing, the sputum production, dyspnea, anorexia, decreased financial capabilities.

d. Acute pain

related to lung inflammation, persistent cough.

e. Hyperthermia

related to active inflammatory process.

f. Intolerance Activity

related to the imbalance between supply and oxygen demand.

g. Knowledge Deficit: about conditions, treatments, prevention

associated with no one to explain, the interpretation is wrong, the information obtained is incomplete / inaccurate, lack of knowledge / cognitive

h. Risk for the spread of infection / re-infection activity related to inadequate primary defenses, decreased ciliary function / static secretions, tissue damage caused by the spread of infection, malnutrition, environmental contamination, lack of information about the bacterial infection.
READ MORE - List of Pulmonary Tuberculosis Nursing Diagnosis NANDA

Nursing Home / Home Care Mattresses

Nursing Home / Home Care Mattresses Size: 75" x 35"

Product Description

GF1500-175-1633 Size: 75" x 35" Features: -Economical, innerspring mattress. -Designed specifically for nursing homes and home care use. -Vented and reversible. -Mattress dimensions: 35'' width, 7'' height. -Easy to maintain, comfortable. -One year limited manufacturer warranty. Specifications: -Meets 16 CFR 1633 requirements. -Weight capacity: 350 lbs. -Overall dimensions: 7'' H x 35'' W x 75''-84'' D.

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3M Littmann Cardiology III Stethoscope

3M Littmann Cardiology III Stethoscope

Product Description

Littmann Cardiology III Stethoscope, Adult Ideal use for Cardiology or other High Performance adult and pediatric applications.

Features two tunable diaphragms (adult and pediatric) for listening to both low and high frequency sounds. Two-tubes-in-one design helps eliminate tube rubbing noise. The pediatric side of the chestpiece easily converts to a traditional bell by simply replacing the diaphragm with the nonchill bell sleeve included with each stethoscope.

Offers a solid stainless steel chestpiece, nonchill rims, and an adjustable doubleleaf binaural spring. 3M Littmann Snap Tight Soft-Sealing eartips provide an excellent acoustic seal and comfortable fit.

READ MORE - 3M Littmann Cardiology III Stethoscope