10 Questions
What is the purpose of amniotomy during labor?
To increase the speed of labor by allowing the fetal head to contact the cervix directly
Which position is recommended during amniotomy?
Dorsal recumbent position
What is the purpose of performing an episiotomy?
To release pressure on the fetal head and possibly shorten the second stage of labor
Which type of episiotomy involves a surgical incision on the perineum from the vaginal opening straight down?
Midline episiotomy
What is the primary indication for a cesarean birth?
Dystocia
Why is sterile technique essential during a cesarean birth?
To reduce the risk of infection for both mother and baby
What is a common nursing diagnosis for a woman after a cesarean birth?
Fear related to impending surgery
What should health care personnel establish during the labor process to support the woman?
'Helping relationship' for confidence and support
In a cesarean birth, what other health care personnel should be coordinated with?
'Anesthesiologist, surgeon, pediatrician/neonatologist, and recovery room/nursery personnel'
What Latin word does 'cesarean' come from and what does it mean?
'Caedore', meaning to cut
Study Notes
Amniotomy
- Artificial rupturing of membranes during labor to allow the fetal head to contact the cervix more directly, increasing the efficiency of contractions and speeding up labor
- Performed in dorsal recumbent position using an amniohook or hemostat
- Disadvantage: at risk for cord prolapse
Episiotomy
- Surgical incision of the perineum to release pressure on the fetal head with birth and shorten the last portion of the 2nd stage of labor
- Two types:
- Midline episiotomy
- Mediolateral episiotomy (done with local anesthetic)
- Episiorrhaphy: surgical repair of injury to the vulva by suturing
Cesarean Birth
- Birth accomplished through an abdominal incision into the uterus
- One of the oldest types of surgical procedures known
- More hazardous than vaginal birth, but safer compared to other surgical procedures
- Originated from the Latin word "Caedore", meaning "to cut"
Indications for Cesarean Birth
- Maternal factors:
- CPD
- Active genital herpes pappiloma
- AIDS or HIV positive virus
- Cervical Cerclage
- Severe Hypertension
- Dystocia
- Previous C/S
- Elective – no indicated risks
- Placental factors:
- Placenta Previa
- Abruptio Placenta
- Fetal factors:
- Fetal macrosomia
- Fetal Distress
- Hydrocephalus
Nursing Diagnosis and Implementation
- Risk for infection related to a surgical incision
- Fear related to impending surgery
- Pain related to a surgical incision
- Deficient fluid volume related to blood loss from surgery
- Powerlessness related to medical need for cesarean birth
- Implementation:
- Establish a helping relationship during labor process
- Woman and her partner should feel confidence in healthcare personnel
- Sterile technique is essential
- Provide "talk time" after procedure
- Coordinate with other healthcare personnel (anesthesiologist, surgeon, pediatrician or neonatologist, and recovery room or nursery personnel)
Learn about amniotomy and episiotomy procedures during labor, their purposes, positions, materials needed, and associated risks. Explore the nursing management strategies to ensure fetal health and safety during childbirth.
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