📌 NCLEX Topic: Cesarean Birth (C-Section)

📌 NCLEX Topic: Cesarean Birth (C-Section)

NCLEX Topic: Cesarean Birth

Description:

A cesarean birth is a surgical procedure used to deliver a fetus through a transabdominal incision in the uterus. It is performed when vaginal delivery poses risks to the mother or fetus, or when complications arise during labor.

Indications for Cesarean Birth:

  • 1️⃣ Fetal Distress:
    • Non-reassuring fetal heart rate patterns (e.g., late decelerations, bradycardia).
  • 2️⃣ Maternal Complications:
    • Severe preeclampsia or eclampsia.
    • Active genital herpes or other infections (e.g., TORCH infections).
    • Placenta previa or abruptio placentae.
  • 3️⃣ Fetal Conditions:
    • Cephalopelvic disproportion (CPD).
    • Malpresentation (e.g., breech or transverse lie).
    • Macrosomia (large baby).
  • 4️⃣ Obstetric Complications:
    • Prolapsed umbilical cord.
    • Multiple gestation (twins, triplets).
    • Failure to progress in labor.
  • 5️⃣ Elective Reasons:
    • Previous cesarean delivery (VBAC may not be attempted in all cases).
    • Maternal request (in certain circumstances).

Preoperative Nursing Interventions:

  1. Prepare the Client:
    • Explain the procedure and provide emotional support, especially if it is an emergency.
    • Ensure informed consent is obtained.
  2. Prepare for Surgery:
    • Establish an IV line for fluids and medications.
    • Insert an indwelling urinary catheter to monitor output.
    • Administer preoperative medications (e.g., antibiotics).
    • Shave and clean the abdominal area as prescribed.
  3. Diagnostic Testing:
    • Verify results of preoperative tests (e.g., blood type, Rh factor, and CBC).
    • Ensure fetal monitoring is continuous.
  4. Positioning:
    • Position the client with a wedge under the right hip to avoid supine hypotensive syndrome.

Postoperative Nursing Interventions:

  1. Monitor Vital Signs and Fundus:
    • Assess for uterine atony and bleeding.
    • Perform fundal assessments to ensure the uterus is firm and contracted.
  2. Assess Incision:
    • Monitor for signs of infection (redness, warmth, swelling, drainage).
  3. Pain Management:
    • Administer prescribed analgesics.
    • Encourage early ambulation to prevent venous thromboembolism (VTE).
  4. Monitor for Complications:
    • Infection: Burning or pain on urination (bladder infection), foul-smelling lochia (endometritis).
    • Thromboembolism: Pain, redness, or swelling in the extremities.
    • Pulmonary issues: Productive cough or chills may indicate pneumonia.
  5. Encourage Bonding and Breastfeeding:
    • Facilitate skin-to-skin contact and early initiation of breastfeeding.

Risks and Complications of Cesarean Birth:

  • Infection: Endometritis, surgical site infections.
  • Hemorrhage: Risk of excessive blood loss.
  • Venous Thromboembolism (VTE): Due to immobility post-surgery.
  • Delayed Healing: Especially in clients with obesity or diabetes.
  • Neonatal Complications: Respiratory issues due to lack of vaginal squeeze.

Test-Taking Strategy:

  • Preoperative: Consent, IV access, catheterization, emotional support.
  • Postoperative: Monitor fundus, incision, and signs of complications.
  • Avoid high-Fowler’s position during pregnancy (risk of supine hypotensive syndrome).
  • 💡 ABCs and Safety: Focus on interventions that promote oxygenation, circulation, and client safety.

Summary for NCLEX:

  • ✅ Cesarean Birth: Surgical delivery through an abdominal and uterine incision.
  • ⚠️ PRIORITY: Preoperative preparation and postoperative monitoring to prevent complications.
  • 🩺 Key Complications to Monitor: Hemorrhage, infection, thromboembolism, and neonatal respiratory distress.