Before we go into the indications for caesarean section, let us have a brief understanding of what Caesarean section is all about.
Caesarean section is defined as the delivery of a baby through an incision in the uterine and abdominal wall after 28th weeks of gestation.
Indications For Caesarean Section
- Cephalon-pelvic disproportion.
- Previous caesarean section for disproportion or previous classical caesarean section.
- Malpresentation and abnormal lie e.g transverse lie.
- Fetal distress when the cervix is jot fully dilated.
- Maternal condition such as eclampsia, severe pre-eclampsia, chronic nephritis, hypertension, diabetes mellitus.
- Previous successful repaired vesico-vaginal fistula.
- Previous rupture of uterus.
- Failed trial of labour.
- Prolapse of the umbilical cord when the cervix is not fully dilated.
- Bad obstetric history.
- Elderly primigravida who has been infertile for years.
- Carcinoma of the cervix complicating pregnancy.
- Gynaetresia that is, abnormal narrowing for the vagina.
- Obstructed labour due to cephalon-pelvic disproportion, fibroids or ovarian tumors.
- Cervical dystocia.
Read Also: Nursing Care of New Born Baby in the first 48 hours
Possible Nursing Diagnosis of a Patient Undergoing Caesarean Section
Pre-Operative Nursing Diagnosis
- fear related to the unknown outcome of surgical procedure evidenced by her facial expression.
- Deficient knowledge related to surgical procedure evidenced by her numerous questions.
- Sleep deprivation related to fear of caesarean section evidenced by long time sitting onn the bed at night.
Nursing Objective
Patient will experience less fear within twenty to thirty minutes of nursing intervention
Nursing Intervention
- Reassure her that the surgery will be successful.
- Admit her near patient whose surgery was successful
- Encourage her to ask questions.
- Explain the procedure to her.
Scientific Rationale
- Reassurance allays fear.
- Seeing patient who had successful caesarean section will instill hope in her.
- Her question will reveal areas of nurse’s need for actions.
- Her knowledge of the procedure will enable her to appreciate it.
Evaluation
Patient experienced less fear after 35 minutes or nursing intervention.
Post-Operative Nursing Diagnosis
- Ineffective breathing related to effect of anesthesia evidenced by noisy breathing.
- Acute pain related to surgical incision evidenced by her verbalization of pain.
- Impaired tissue integrity related to surgical incision evidenced by open abdominal wound.
- Imbalanced nutrition: less than body requirements related to dietary restriction evidenced by her poor skin tugor.
- Activity intolerance related to effect of anaesthesia evidenced by her in ability to sit up in bed without support.
- Powerless related to surgical incision evidenced by inability to raise her body from bed without support.
Nursing Objectives
- Patient will maintain effective breathing pattern within twenty minutes to fourty minutes of nursing intervention.
- Patient will verbalize less pain within thirty to fifty minutes of nursing intervention.
Nursing Intervention
- Check vital signs, especially respiratory rate.
- Suction excess mucous.
- Turn patient’s head to the side.
- Keep patient in an airy environment.
- Administer oxygen in need be.
- Reassure patient, place her any position suitable for her.
- Employ many hands in changing her position.
- Administer prescribed medications.
Scientific Rationale
- Respiratory rate reveals any deviation from normal respiratory pattern.
- Removal of excess mucous clears the airway.
- This position promotes drainage of mucous.
- Airy environment promotes ventilation, oxygen strengthens her breathing pattern.
- Reassure will enable her to pain, suitable position lowers her perception of pain.
- Many hands will change her position without aggravating the pain.
- Analgesic raises pain threshold.
Possible Complication of Caesarean Section
- Haemorrhage
- Infection
- Abdominal distension.
- Paralytic ileus.
- Pulmonary embolism/thrombosis.
- Burst abdomen
- Pulmonary collapse.
- Intestinal obstruction.
- Abdominal pain.
- Anaemia
- Uterine rupture.
We hope this information was helpful. Feel free to ask questions in the comment section below.