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Questions and Answers
What is the purpose of amniotomy during labor?
What is the purpose of amniotomy during labor?
- To reduce the risk of a cord prolapse
- To prevent infection in the birth canal
- To increase the speed of labor by allowing the fetal head to contact the cervix directly (correct)
- To relieve pain during contractions
Which position is recommended during amniotomy?
Which position is recommended during amniotomy?
- Lithotomy position
- Sims' position
- Dorsal recumbent position (correct)
- Fowler's position
What is the purpose of performing an episiotomy?
What is the purpose of performing an episiotomy?
- To increase fetal head pressure during birth
- To accelerate the first stage of labor
- To prevent excessive bleeding post-delivery
- To release pressure on the fetal head and possibly shorten the second stage of labor (correct)
Which type of episiotomy involves a surgical incision on the perineum from the vaginal opening straight down?
Which type of episiotomy involves a surgical incision on the perineum from the vaginal opening straight down?
What is the primary indication for a cesarean birth?
What is the primary indication for a cesarean birth?
Why is sterile technique essential during a cesarean birth?
Why is sterile technique essential during a cesarean birth?
What is a common nursing diagnosis for a woman after a cesarean birth?
What is a common nursing diagnosis for a woman after a cesarean birth?
What should health care personnel establish during the labor process to support the woman?
What should health care personnel establish during the labor process to support the woman?
In a cesarean birth, what other health care personnel should be coordinated with?
In a cesarean birth, what other health care personnel should be coordinated with?
What Latin word does 'cesarean' come from and what does it mean?
What Latin word does 'cesarean' come from and what does it mean?
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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)
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