nursing care post op Sectio Caesarea
(Cesarean section)
.
Understanding Sectio Caesaria (cesarean section)
There is some understanding of Caesaria sectio:
Sectio Caesaria is a means of delivery of a fetus by incision in the wall of the uterus through the abdominal wall. (Rustam Mochtar, 1992).
(Cesarean section)
.
Understanding Sectio Caesaria (cesarean section)
There is some understanding of Caesaria sectio:
Sectio Caesaria is a means of delivery of a fetus by incision in the wall of the uterus through the abdominal wall. (Rustam Mochtar, 1992).
Sectio Caesaria is an artificial childbirth where the fetus was born through an incision in the abdominal wall and uterine walls with the terms intact uterus and fetal weight above 500 grams (Sarwono, 1991).
askep-scJadi operation cesarean section (sectio Caesarea) is a surgery to give birth to the fetus (artificial birth), through an incision in the abdominal wall and uterus so that the front of the babies to be born through the abdominal wall and the abdominal and uterine wall so that children born with intact and healthy.
Indications Sectio Caesaria
Operation sectio Caesarea done if birth pervaginal might cause risks to the mother or the fetus, with consideration of the things that need to act normal childbirth old SC / failure of the normal birth process (Dystasia)
Indications sectio Caesaria on Mother
Cevalo-pelvic disproportion (imbalance between the size of the head and pelvis)
Uterine dysfunction
Soft tissue dystocia
Placenta previa
His weak / weakening
Threatening uterine rupture
Young or old primi
Parturition with complications
Placental problems
Indications Sectio Caesaria In Children
Large fetus
Fetal distress
Fetus in a breech or transverse position
Fetal distress
Kalainan layout
Hydrocephalus
Sectio Caesaria Contra Indications:
Caesarian sectio generally not performed on a dead fetus, shock, severe anemia before addressed, severe congenital abnormalities (Sarwono, 1991)
Type - Type Operations Sectio Caesarea
1. Abdomen (abdominal sectio Caesarea)
a. Sectio Caesarea transperitonealis
SC classic or corporal (with longitudinal incision on the corpus uteri)
Performed by making an incision along the length of the corpus uteri is approximately 10 cm.
Pros:
Quickly remove the fetus
Not lead to complications of bladder interested
The incision can be extended proximally or distally
Shortage
Infection is easily spread because there is no intra-abdominal reperitonealis good
For subsequent births are more common spontaneous uterine rupture
SC ismika or profundal (low servical with an incision in the lower segment of the uterus)
b. SC ektra peritonealis ie without opening the parietal peritoneum thus opening the abdominal cavity
Is done by conducting konkat transverse incision on the lower segment of the uterus (low transverse servical) is approximately 10 cm
Pros:
Wound suturing easier
Wound closure with a good reperitonealisasi
Overlap of the peritoneal flap splendidly to contain the spread of uterine contents into the peritoneal cavity
Bleeding is not so much
The possibility of spontaneous uterine rupture decreases or smaller
Disadvantages:
Wounds can be widened to the left, right, and bottom so it can cause uterine rupture, resulting in bleeding a lot
Complaints on high postoperative bladder
2. Vagina (section Caesarea vaginalis)
According to the incision on the uterus, sectio Caesarea can be done as follows (Mochtar, Rustam, 1992):
1. Incision lengthwise (longitudinal)
2. Transverse incision (Transversal)
3. Incision letter T (T insicion)
Prognosis Operations Sectio Caesarea
On Mother
First morbidity and mortality for the mother and fetus high. At the present time due to rapid advances in surgery techniques, anesthesia, provision of fluids and blood, and antibiotic indications this figure is declining.
Maternal mortality in hospitals with good facilities and operations by force - force that deft is less than 2 per 1000.
In children
As is the case with his mother, the fate of children born with a lot depending on the sectio Caesaria state the reason for doing sectio Caesarea. According to statistics in the country - a country with antenatal surveillance and good intra-natal, perinatal mortality post Caesaria sectio ranged between 4 and 7%. (Sarwono, 1999).
Complications Operations Sectio Caesarea
Possibilities that arise after this surgery include:
1. Puerperal infection (Ruling)
- Lightweight, with a temperature rise within a few days
- Medium, higher temperatures increase accompanied by dehydration and slight stomach bloating
- Weight, peritonealis, sepsis and bowel paralytic
2. Bleeding
- Many blood vessels are severed and open
- Bleeding in the placental bed
3. Bladder injury, pulmonary embolism and bladder complaints when peritonealisasi too high
4. High likelihood of spontaneous rupture in subsequent pregnancies
Diagnostic Examination
Fetal monitoring fetal health
ECG monitoring
JDL with differential
Electrolyte
Hemoglobin / Hematocrit
Blood group
Urinalysis
Amniocentesis for fetal lung maturity as indicated
X-ray examinations as indicated.
Ultrasound to order
(Tucker, Susan Martin, 1998)
Nursing Sektio Caesaria
1. Fluid Volume deficit b.d Bleeding
Objective: Not happening fluid volume deficit, balanced between intake and
both quantity and quality of output.
Intervention:
a.Kaji conditions hemodynamic status.
R / operating expenses due to excess fluid is a major factor problem.
b.Ukur daily expenses.
R / amount of fluid is determined from the amount of the daily requirement coupled with the amount of fluid lost during surgery and post daily.
c.Berikan amount of replacement fluids daily.
R / transfusion may be required under conditions of massive bleeding.
d.Evaluasi hemodynamic status.
R / Assessment can be done on a daily basis through a physical examination.
2. Disturbance Activities bd weakness, decreased circulation
Objective: Kllien can perform activities without complications
Intervention:
a.Kaji rate the client's ability to move.
R / Maybe the client does not undergo significant changes, but need to watch out for the massive bleeding menccegah client's condition worse.
b.Kaji activity influence the condition of the wound and the general condition of the body.
R / activity stimulates increased vascularization and pulsation reproductive organs, but it can affect postoperative wound conditions and reduced energy.
c.Bantu clients to meet the needs of day-to-day activities.
R / Mengistiratkan clients optimally.
d.Bantu clients to take action in accordance with the capability / condition of the client.
R / Optimizing client's condition, on abortion imminens, absolute rest is necessary.
e.Evaluasi client capability development activities.
R / Assess the general condition of the client.
3. Impaired sense of comfort: pain bd postoperative wound
Objective: Clients can adapt to the pain experienced.
Intervention:
a.Kaji pain conditions experienced by the client.
R / Measurement of pain threshold values can be done with the scale
and dsekripsi.
b.Terangkan pain suffered by clients and their causes.
R / Improving coping clients in pain management guidance.
c.Ajarkan distraction techniques.
R / reduction of pain perception.
d.Kolaborasi analgesic administration.
R / Reduce pain onset can be done by giving oral or systemic analgesics in a broad spectrum / specific.
4. High risk of infection bd bleeding, postoperative wounds.
Objective: There is an infection during treatment of bleeding and wound
operation.
Intervention:
a.Kaji state output / dischart that out, the number, color, and odor from the surgical wound.
R / changes that occur at any time studied dischart dischart out. The existence of a darker color with an offensive smell may be a sign of infection.
b.Terangkan the importance of wound care clients during the postoperative period.
R / Infection can arise due to lack of cleanliness of the wound.
c.Lakukan the cultures on dischart.
R / A variety of germs can be identified through dischart.
d.Lakukan wound care.
R / Incubation germs in the wound area can cause infection.
e.Terangkan on how to identify the signs inveksi clients.
R / Various clinical manifestation may be a nonspecific sign of infection, fever and increased pain may be a symptom of infection.
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