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CAESAREAN

DELIVERY

I. INTRODUCTION

Cesarean birth is the birth of a baby by surgery. The doctor makes an incision (cut) in the
belly and uterus (womb) and then removes the baby. The surgery is called a cesarean
section or c-section.
The natural way for a baby to be born is through the mother's vagina (birth canal). But
sometimes vaginal birth isn't possible. If the baby have certain problems before or during
labor, c-section may be safer than vaginal birth.
The health care provider may plan your cesarean in advance. Or one may need an
emergency (unplanned) c-section because of a complication that arises for the baby
during pregnancy or labor.

• The mother having twins. with full recovery taking less time than a cesarean. C-section may be more expensive than a vaginal birth. • The baby has problems during labor that show it is under stress. instead of the head. such as a slow heart rate.The health care provider may suggest to have a c-section for one or more of these reasons: • The mother already had a c-section in another pregnancy or other surgeries on your uterus. • The baby's buttocks or feet enter the birth canal first. Women can expect to stay 3 to 4 days in the hospital after a c-section. triplets or more. where it could be squeezed or flattened during vaginal delivery. Usually. This is called a transverse position • There are problems with the placenta. • The mother have an infection like HIV or genital herpes. This is the organ that nourishes your baby in the womb. • The baby has a certain type of birth defect. . Placental problems can cause dangerous bleeding during vaginal birth. A woman who has a c-section usually takes longer to recover than a woman who has had a vaginal birth. This is called a breech position. This is called umbilical cord prolapsed. This is sometimes called “fetal distress. • Labor is too slow or stops. the hospital stay for vaginal birth is 2 days. • The baby is too big to pass safely through the vagina. • The baby's umbilical cord slips into the vagina. • The baby's shoulder enters the birth canal first. Full recovery usually takes 4 to 6 weeks. instead of the head.” • The mother have a serious medical condition that requires intensive or emergency treatment (such as diabetes or high blood pressure).

. ➢ To develop preventive strategies for the client who is at risk for Cesarean birth complications. ➢ To formulate appropriate nursing care plan related to Cesarean birth for the achievement and effectiveness if management. OBJECTIVES General Objectives To gain knowledge about Cesarean birth and to relate it with the client in terms of providing proper nursing management.II. Specific Objectives ➢ To describe specific indications for Cesarean birth such as previous Cesarean birth by classic incision and fetal distress ➢ To assess a woman for effective post operative needs.

. Patient X undergone Cesarean birth in order to reduce the possibility of further complications since the fetus is very immature. Lipa City.III. Her attending physician. She and her family is recently residing at Sabang. Dr. 2008. PATIENT’S PROFILE Patient X is a 28-year old woman who delivered her third baby last August 10. Duque scheduled her for an immediate delivery since she already experiences symptoms of early preterm labor. her previous Cesarean birth with her second kid whom she delivered just a year ago by classic incision was contraindicated for vaginal birth or normal delivery. Likewise.

Since she’s the home-maker of the family. Past Health History Patient X. B. On the other hand. she noticed increased vaginal discharge and spotting which leads her to consult her physician and there she realized that she will be having preterm labor through Cesarean birth. all the household chores were left alone to her. she complained that she always experience difficulty in walking or even with minimal activities because of abdominal tightening and cramping. together with rearing and their children. while his husband is working in feed-mill company. CLINICAL APPRAISAL A. also because of her varicosities. Personal History Walking for 30 minutes early in the morning was the usual daily exercise of Patient X before starting the day. at her third pregnancy has already completed her tetanus toxoid immunizations.IV. She has no noted allergic responses to drugs. According to her. during her 8th months of gestation. she seldomly are fruits and consumed milk. Family History of Diseases A family history of respiratory disorder especially tuberculosis was reported by Patient X. as well as those foods she craved for. . But discomforts she experienced during the later months of her pregnancy interfered with her activities at home. nutrition during her pregnancy was given little attention and importance. Due to insufficient income. During her 7th month of pregnancy. C. She restricted taking medicines by the entire period of pregnancy except for prescribed mild analgesics such as paracetamol.

Social History Patient X finished her secondary studies. On the other hand. also because of her varicosities. As soon as he got married and pregnant. she felt like almost over-stressed. Laguna where she assembled fluorescent bulbs and the like.000-4. Furthermore. At an early age. during her 8th months of gestation. His husband’s income which is P4.D. Due to this situations. She consulted all her inner feelings to his husband and together they made decisions to solve problems. Her baby was gray in color which is indicative of infection. she tried to be positive thinker and lean on God. she has been through a lot of work experiences but she spent most of her years working at an electronic company in Cabuyao. Psychological History Patient X experienced great burden as her baby was detected to be very immature and has some complications. F. Though in the midst of problems. she noticed increased vaginal discharge and spotting which leads her to consult her physician and there she realized that she will be having preterm labor through Cesarean birth .300 a month was sometimes not enough but their parents readily sustain additional support if they’re in need. History of Present Illness During her 7th month of pregnancy. she resigned at work and relied family’s needs to his husband. she complained that she always experience difficulty in walking or even with minimal activities because of abdominal tightening and cramping. her baby has severe sternal retractions as sign of respiratory distress that’s why the baby was placed on ventilator and must undergo a lot of examinations. E.

V. 3. . Pain after Appearance when reaching for surgery is inevitable. The client is conjunctiva anemic from poor pregnancy nutrition or excessive blood loss at >Pupils are equal birth. Palpation >Listless and Abnormal. something Minimal movement and >Hand pressure activity may lessen her against her discomfort. the client her hair and wear will not bother her on her clothing appearance. General Observation > Exerts energy Normal. Eyes Inspection >Has pale Abnormal. and reactive to Normal light. Hair Inspection and >Tend to lose Normal. And abdomen probably because of >Seldomly combed uneasiness. PHYSICAL ASSESSMENT ORGANS METHOD FINDINGS ANALYSIS and RATIONALE 1. metabolism was increased and hair growth was rapid. Face Inspection and >No noted edema Normal Palpation 4. her hair is lost. 2. As the womanÕs body returns to a normal metabolism level. During palpation quantity of hair pregnancy. Diet during ÒstringyÓ pregnancy is deficient in nutrients. so many hairs reached maturity at the same time.

the distended uterus obstructed the amount of venous blood returning to the heart. During pregnancy. Respiration Auscultation >Respiratory Rate: Normal 21bpm >No noted adventitious 8. Normal >No noted cracks Palpation and fissures Normal. Breasts Inspection >Nipples are erect. BP Palpation and >110/70 mmHg Normal. *Comparing the womanÕs pressure with her pre-pregnancy level is much better to evaluate BP rather than with standard BP ranges. stroke volume reduces the pulse rate to below 60-70bpm 7. after birth to accommodate the increased blood volume returning to the heart. The clientÕs Auscultation normal pressure during pre-pregnancy is always 110/70 Ğ 110/80 mmHg. Pulse Palpation >Pulse Rate: Normal: WomanÕs pulse 70bpm rate during post partal Site: Radial period is usually slightly slower than normal. .5. During the 3rd >Feel firm and postpartal day/breast warm tissue increases in size as milk forms within breasts ducts(filing) 6.

This leads to pinkish streaks which >Vertic al incisicion are c alled stride through both the gravidarum. the white in color on abdominal w all must the sides of stretch to ac c ommodate abdominal w all. it. palpable 2 Normal. During Uterus pinkish streaks. temperature elevation will return to normal. 10. This part of the proc ess c alled involution whereby the uterus and other reproductive organs return to t heir nonpregnant state. These abdominal skin and lighten days to weeks uterus after birth which are Palpation >Old wide sc ar c alled striae albic antes which also runs or atrophic ae. through the Normal.9oC Normal: A postpartal Site: Axill ary woman show s a slight inc rease in temperature during the first 24 hours after birth bec ause of dehydration that oc c urred during labor. But if s he already rec eives adequate fluid through IV fluid. The client contractile portion undergone c esarean of the uterus. birth.9. Normal. . Abdomen Inspection >Presenc e of Normal. inc reases in size. This incision is c alled classic cesarean >Position in cm: incision. as the uterus some are silvery. This stretching (plus possibly inc reased adrenal cortex activity) c an rupture and atrophy of small segments of connective layer of the skin. The clients first 2 k ids w ere delivered with this type of c esarean incision. pregnancy. This w as the fingerbreaths / 2 cm disadvantage of classic below the umbili c us type of incision. Temperature >36.

the client is not yet breastfeeding her baby. Furthermore. If pattern /color is reversed/ that indicates that placental fragments have been retained or that uterine contraction is decreasing and new bleeding is beginning. hematoma. Normal. This also show s good uterine contraction. edema . 12. Red must first occur before the rest. This is the result of vaginal discharge of pooled lochia.11. Indicates that nothing in the portion of the placenta has been retained. Delivery w as Area laceration or done through Cesarean episiotomy birth. Perineal Inspection >Absence of Normal. Normal. erythema. >No noted ecchymosis. It is the clientÕs increase. An offensie odor usually indicated that uterus has been infected. Lochia is red menstrual blood for the 1st 3 days (lochia rubra). first few times out of bed. Lochia Inspection >Amount: Tends to Normal. >Odor: The same as Normal. oxytycin during breastfeeding >Color: Red strengthens uterine contractions. Mothers who breastfeed tend to h ave less lochial discharge from those who do not >Consistency: because the natural Contain no large release of the hormone clots. Lochia should not have offensive odor.

small Normal. abili ty to sense filli ng may be inadequate to >Sounds dull. 15. . initiate voiding after surgery. >Hard. Normal. During >Presence of pregnancy. This leads to obstruction to blood flow specially to superficial veins of the legs. but Normal. Bowel Sounds passage of stool evacuation may be Inspection through the bowel difficult due to the pain may be slow of incision.13. This is during empty bladder. This may be amount of stool effect of abdominal surgery and anesthesia 14. Peripherals Inspection >No noted edema. The bladder per day is more was handles and than 30mL but only displaced during Palpation voids twice daily surgery its tome or Percussion after surgery. Bladder Inspection >Urinary output Normal. Bowel Auscultation >Active. Normal. additional varicosities weight by the growing (distended veins) fetus tends to b e push downward by gravity.

360 PDW 15.5 g/dL 12.4 MO# 0.0 Ğ 96.5 % 4.2 10^3/UL 0.4 fL 80. VI.0 MCV 91.73 10^6/UL 4.8 H% 36. LABORATORY RESULTS TEST RESULT UNIT REFERENCE VALUE WBC 6.8 Ğ 11.7 15.1 Ğ 0.2 10^3/UL 1.0 LY 22.0 PCT 0.0 Ğ 31.6 g/dL 32.0 Ğ 40.435 * H% 0.7 pg 27.0 Hct 34.7 PKT 419 * H10^g/L 150 Ğ 450 MPV 6.0 MO 2.1 % 38.0 RDW 18.2 Ğ 3.7 % 22.5 Ğ 17.40 Hgb 11.0 LY# 1.5 RBC 3.1 Bt ÒOÓ+ HBS Ag Ğnon-reactive .0 Ğ 10.0 Ğ 51.6 10^3/UL 1.190 Ğ 0.0 Ğ 16.1 * L fL 7.0 Ğ 66.1 *H % 11.6 Ğ 13.4 Ğ 6.9 10^3/UL 5.0 MCHC 33.20 Ğ 5.0 Ğ 8.0 MCH 30.0 Ğ 36.0 GR 74.6 GR# 5.

ANATOM Y AND PHYSIOLOGY . .VII. UTERUS .

The corpus is made up of two layers of tissue. When an egg is fertilized (joined with sperm). lower portion of the uterus is the cervix. In women of childbearing age. extend from either side of the uterus and act as a channel for eggs from the ovary to travel to the uterus. The narrow. upper part is the corpus. The outer layer of the corpus (myometrium) is muscular tissue that expands during pregnancy to hold the growing fetus and contracts during labor to deliver the child. Menstruation occurs when this tissue is not used. and passes out through the vagina. The lower narrow portion of the uterus is called the cervix and it protrudes downward into the opening of the vaginal canal. Each month. The vaginal canal extends downward to the external female genitalia. the broader. disintegrates. the thickened uterine lining sloughs off in a process known as menstruation . or Fallopian tubes. pear-shaped organ located in a woman's lower abdomen between the bladder and the rectum. If an egg is not fertilized. endometrial tissue grows and thickens in preparation to receive a fertilized egg.The uterus (womb) is a hollow. it becomes embedded in the wall of the uterus (whose lining becomes thickened) where the fertilized egg grows into an embryo and later a fetus. The uterine tubes. the inner layer of the uterus (endometrium) goes through a series of monthly changes known as the menstrual cycle.

pos i t i on instead of the head Quic kTime™ and a dec ompress or are needed to see this picture. s u c h as a s l o w hear t rate prevents pushing to accomplish the pelvic division of labor hypertensive mother . PATHOPHYSIOLOGY Risk Factors Consequences Delivery previous cesarean with a "classical" vertical the prev io us sc ar m ay b e rup t ured if vag i na l d e li very w ill be uterine incision or more than one previous c. instead of the head the baby i s in a b r eech ( bott o m f i rst ) or t rans v erse (s id e w ay s) baby's shoulder enters the birth canal first. done section diabetic mother the baby i s ex pected to be v ery l a r ge ( a cond i t i on kno w n as m ac ros o m i a). can cause dangerous bleeding during vaginal birth placental problems baby has p rob le m s dur i ng l ab o r that s ho w i t Òfetal distressÓ i s under s t ress . baby's buttocks or feet enter the birth canal first.VIII.

NURSING CARE PLAN ASSESSM ENT NUR SING SCIENTIFIC PLANNING INTERVENTION RATIONA LE EXPECTED DIAGNOSIS EXPLANATION OUTC OME S: ÒNahihirapan akong Constip ation related to Decreased in normal After 1 hour of nursing 1. abdomen excessively hard. 5. the client data. To check if there intervention. formed stool accompan ied by defecation pattern. Encour age activity and exercise within limits of individual ability to stimulate >to aid in easy contraction of the defecation intestine. walkin g. normal vital sign. defecation pattern. the client defecation w ill regain her normal are any elevation in the w ill regain her normal O:>hard. vegetables and whole grains to improv e consistency of stool and facilitate passage through >to increase intestinal colon. peristalsis 4. >to improve bow el 3.Pprovide laxatives or suppositories . Monitor vital signs > to serve as base line After 1 hour of nursing dumumiÓ post partum delivery frequency of intervention. Identify elements >to know the defecation passage of stool and that usually stimulate contributing factors of >distended or passage of bow el activity like the problem. Encour age a diet of motility balanced fiber and bulk like fruits. >percussed stool laxative use and any abdominal dullness interfering factors like taking opioid pain medic ations.IX. dry caffeine. >staining with difficult or incomplete 2.

Advice the client to do the f fg. Assessed the client if > This helps the nurse utilize After 2 hours of nursing umanak. patient will report >Increased f luid intake is patient reported frequency wala pang 3 taon yung huli was handled and displaced frequency and no hesitancy 2. the client began kaya lang sabi ng doctor surgical procedure diff iculty to void in due begin to void at least 30 incontinence. Hindi pa ako be inadequate to initiate output. 5. 6. . ako. itÕstone or on voiding.This >no residual urine voiding pattern is dangerous >bladder sounds dull because . to v oid at least 30 ml/hr. the woman may haveÓ mahirap at masakit.Ó O:> f irm abdomen retention with overflowÓ. >These procedures stimulate the surface to trigger the voiding reflex. dapat normal sana Elimination related to individual experiences a interv ention. > Ensuring privacy and comfort as well as assisting the client to bathroom is of great help to facilitate 3. Promote micturation. increase bladder control. If a as evidence by the clientÕs din..it means that the (empty bladder) womanÕsbladder is continuously under tension.Ó voiding after surgery. urination. -Pour warm water over perineum > This promotes personal -Drink glass of water while hygiene. ASSESSMENT NURSING DIAGNOSIS SCIENTIFIC PLANN ING INTERVENTION RATIONALE EXPECTED OUTCOME EXPLAN ATION S: ÒNoong 11 pa ako Risk for Impaired Urinary The state in which an After 2 hours of nursing 1. and interventions. 4. the client will there is contributing to proper adaptiv e equipment interv ention. Encourage the client to > Relax share his feelings about abdominal musculature.Dalawang araw na akong ability to sense fillings may restricted. Maintain optimal hydration necessary to increase the and no hesitancy on voiding kong pagkaanak na CS during surgery. hindi na gaanong makaramdam eh. mahina daw ang bata at urgency because the bladder ml/hr. incontinence and determine the effect. if not contraindicated or clientÕsurge to v oid. Monitor intake and bladder has filled to capacity verbalization of Ònakaihi na di pa ulit umiihi. Assist administering he prescribed analgesic. 7. sitting on the toilet. Instruct > This women to cleanse the promotes personal integrity perineum and urethra from and provide motivation to front to back. but cannot empty properly. Advice the client to shower rather than baths to prev ent bacteria from entering the urethra.: -Brush/ Stroke inner thigh or abdomen.

DRUG S TUDY .X.

alkaloid s.O. to ergot immediately. pulse the patient. . enhancement of  Monitor blood pressure and palpitations. contractions. relaxation. uterine contractions.2 mg IM q2-4 hours the third stage of pain. Contrac tions ma y dose. sudden change of the smooth Dizziness. after IV days. Decreases milk secretion. w hile monitoring tachycardia.2 mg IV over 1 mi n Bradycardia.  After first IM or IV nasal congestion. use of for 3 hours dosage if severe or more after crampin g occurs. skin labor and before pressure. Name of Drug Classification/Action Indications Adverse Reaction Contraindications Nursing Responsibility Parameters st Brand Name:  Drug that acts on  To prevent and treat  Common:  Pregn ancy:1  Monitor and  Check for the nd Methergine uterus poatpartum Headach e. severe response. for induction or bleeding. or IM use. abdominal crow ning of the rate and uterine Norma l range is Methylergonovine activity of the uterus subinvolution. Dosage and Frequency: muscle. hypotension. male ate by direct stimulation  Uncommon: hypertension. and dosages. 0. P. frequent periods  0.  Hypersensitiv ity w hich may begi n thromboph lebitis. shortening of convulsions. blood loss. Generic Name:  Increases motor by uterine atony or eruptions. pain head.  DonÕt be confused with methergine with terbutaline. muscle continue for up to to 8 hours for 2-7 cramps. reduction of 45 mins.2 mg PO q6 diarrhea. vascular disease. spasm. light resistant container. occlusive of uterine to a maximum of 5 labor and reducing nausea. preeclampsia in vital signs. chest and eclamps ia. and 2 stage of record blood blood pressure of hemorrha ge caused hypertension. report 120/80 mmHg. arterial labor.  Store tablets tightly closed. Discard if discolored. hyperhidrosis sepsis character and   Rare:  Not to be used amou nt o vaginal  0.. vomiting.

fluid NSAIDs. inf lammatory reactions. colitis signs and symptoms of  GU: infection. taste disorder. flatulence. levels periodically in tinnitus disease. 75 mg. cardiac ALT. retention. interstitial bleeding. peptic antipyretic and anti- ulceration. 50 mg. hyperglycemia  Musculoskeletal: Back. Nephritic syndrome.  Liver function test values night blindness. angioedema . renal or heart failure or  Suppositories: antipyretic effects. they can Brand Na me:  May inhibit  Rheumatoid Arthritis dizziness. Dysmenorrhea  CV: taking aspirin or other especially in patients with Dosage and Frequency: analgesic and Heart failure. in elderly 50 mg. nausea. dysfunction. edema.bleeding. in those with hepatic prostaglandins. can occur in nephritis. bloody diarrhea. anti-inflammatory. pruritis. fluid including peptic ulcers and retention. indigestion. begins. hypertension liver dysfunction. and in those  Tablets: laryngeal edema. Name of Drug Classification/Action Indications Adverse Reaction Contraindications Nursing Responsibility Generic Name:  Nonsteroidal  Ankylosing  CNS:  Contraindicated in patients  Because NSAIDs impair Diclofenalac Sodium inf lammatory drugs spondylitis Aseptic meningitis. hypersensitive to drug and the synthesis of renal   Osteoarthritis anxiety. depression. photosensitivity reaction.  Hepatic: Jaundice. Make first Abdominal distention. bullous eruption. patients undergoing long-  GI: fluid retention. hapatotoxicity  Metabolic: Hypoglycemia. alopecia. drowsiness. dermatitis. allergic purpura. proteinuria despite lack of symptoms. hepatic transaminase. or impaired term therapy. Monitor 25 mg. appetite NSAIDs may mask the change. acute  Serious GI toxicity. porphyria or history of decrease renal blood flow Fenac prostaglandin  Analgesia headache. to produce  Primary irritability allergic reactions after renal impairment. mg epistaxis..  Because of their melena. eye pain. hypertension. breastfeeding. urticaria  Other: Anaphylactoid reactions. 8 weeks af ter therapy constipation. swelling of the disease. papillary patient taking NSAIDs. necrosis. 100 mg  EENT:  Avoid using during late patients. hepatitis. 100 blurred vision. eczema. renal function measurement of abdominal pain or transaminase no late than cramps.  Use cautiously in patients may increase during reversible hearing with history of peptic ulcer therapy. especially lips and tongue. leg or joint pain  Respiratory: Asthma  Skin: Stev ens-Johnson syndrome. pregnancy or while taking diuretics. oliguria. asthma. urticaria. or other and lead to reversible Voltaren synthesis. renal failure. anaphylaxis. these patients closely. Monitor loss. rash. insomnia. diarrhea.

antibiotics. nausea. ultimately leads serum sickness - to cell lysis.: 250-500 mg every and some Gram. Name of Drug Classification/Action Indications Adverse Reactions Contraindications Nursing Responsibility Parameters Generic Name: Classification:  Treatment of  Central nervous  Hypersensitiv ity to  Ask patient about  Dosage adjustment Ampic illin Antibiotic infections caused system: Fever. drug penetrate vomiting the outer  Hematologic: membran e of Agranulocytosis. w hich Anaphylaxis. a low Ampine x. It differs tongue. symptoms of high percentage of ampic illin is able exfoliative hypersensitivity such patients w ith to penetrate dermatitis. like rea ction . from penicillin enterocolitis. diarrhea. group helps the stomatitis. It nephritis (rare) inhib its the third  Respiratory: and final stage of Laryngeal stridor bacterial cell wall  Miscellaneous: synthesis. only by the glossitis.V. sore That amin o mouth or tongu e. rash. or other  Obtain specimen for imp airment.  Gastrointestinal: urticaria. bacteria. hemol ytic Ampici llin acts as anemia. Vatacil  Belonging to the organisms seizure penicillins culture and sensitivity incidenc e of cross- penicillin group of  Dermatologic: test before giving. patients w ith renal Brand Name: Action: strains of micro. any allergic reactions to may be necessary in by susceptible penicillin compon ent of the penicillin. I. presence of an pseudomemb ran amin o group. ous colitis. multiforme. inhib itor of the leukopen ia. and develope d rash 6 hours negative Black hairy anaphylaxis. as erythematous infectious Dosage and Frequenc y: Gram-positive urticaria maculo papular rash. mono nucleosis have I. ampic illin. Clovilin. allergy with other Route of Administration: beta-lactam Erythema  Watch for signs and beta-lactams exists. a competitive eosinoph ilia. gram-negative anemia. encephalo pathy. formulation. ampic illin. V. during therapy with bacteria. enzyme thrombocytopeni transpeptidase. a purpura Transpeptidase  Hepatic: AST is needed by increased bacteria to mak e  Renal: Inter stitial their cell w alls.

which can provide excellent postpartum pain relief for up to 24 hours without the grogginess from systemic narcotics. they should be given systemic narcotics for immediate postpartum pain relief. so there won’t be pressure on your incision. a substance that allows gas bubbles to come again more easily. (This will reduce the risk of pneumonia. and moving and stretching your legs. Simethicone is safe to take while breastfeeding. Gas tends to build up because the intestines are sluggish after the surgery. rotating your ankles. Getting up and moving around will help your digestive system get going again. morphine may be added. make your bowels less sluggish.) Be sure to use both hands or a pillow to support the incision when you cough (good advice for sneezing and laughing. If feeling groggy and possibly nauseated right after surgery. Get the blood going in your legs by wiggling your feet.) There might also be some gas pain and bloating during the first two days. Note: If you’re in great discomfort. the caregiver can give medication to minimize discomfort. By the second day. and make it much less likely that you’ll develop blood clots. Instruct on how to cough or do regular breathing exercises to expand the lungs and clear them of any accumulated fluid. too. Breastfeed on side-lying position or using the football hold. . making the gas easier to expel. which is particularly important if you’ve had general anesthesia. This will help your circulation. If given general anesthesia for surgery. they should be taking a couple of short walks with help from their partner or from a nurse. PROGNOSIS Treatment and management If given an epidural or spinal for your c-section.XI. the nurses may give you some over-the- counter medication that contains simethicone.

S. but make sure that you don't over work yourself T. General light cleaning such as folding laundry. If the pain continues. If one begin to feel pain in the incision area. advice her to try best to keeps the house cleaning to a minimum. avoiding crunches and sit-ups at first. to consult with the doctor. Inform the client of the importance of the entire therapy. H. D. Eat plenty of fruits and vegetables to prevent constipation. This holds true for Caesarean deliveries. or moving furniture.Advice client to take prescribed medications and to finish the entire prescription even if it starts feeling better. Instruct her to cleanse the genitals giving special attention to perineum and urethra. As tempting at the first days at home. O. Avoid heavy duty cleaning such as mopping. etc.Advice the client to take shower if not tolerated having baths. loading the dishwasher. before resuming any exercising. .Advice client to maintain optimal hydration by drinking 6-8 ounces of water every day. Remember. is fine. He or she will tell how much exercise is safe at this point.Recommend the couple to sustain intercourse for 6 weeks after the birth of your baby.Encourage the client to comply with the doctor’s scheduled follow up check-up for evaluation and continued care. stop exercising at once. DISCHARGE PLANNING M. vacuuming.XII. don´t jump into anything too quickly. It is important though.Tell the client that it is normally safe to resume an exercise routine 6-8 weeks after a Caesarean. E. be sure to let the doctor know as soon as possible.Advice the patient to follow all the doctor’s order and prescriptions. Try beginning with a light exercise routine. Most likely he or she will instruct to begin light exercise.

Department of Nursing for developing competitive students by integrating learning experiences outside the school premises. Brucal. To Lyceum of the Philippines.Bats. guiding our minds and hearts to be open to the needs of others and letting us fulfill this project. to the entire management and staff for providing us new hospital experiences that challenged us to grow. Jinny M.XIII. not only by nudging us to acquire new approaches at work and nursing management but also acceptable behaviors and attitudes. for giving us professional and moral support. To our Clinical Instructor. learn and appreciate more the essence of nursing and rendering care to clienteles. ACKNOWLEDGMENT We would like to express our sincerest gratitude and appreciation to the following: To Lipa City District Hospital.. And most of all to God Heavenly Father for blessing us talents and opportunities we have. . Mrs. To all our friends who didn’t wait for us to call them in finishing this requirement.

Carpenito. Rita.gov/MEDLINEPLUS.A. 2000.google. et al. a Woters Kluwer Company.:Nursing Diagnosis:Application to Clinical Practice.: Nurse’s Pocket Guide: Prioritized Interventions and Rationales. 6th edition.: Maternal and Child Health Nursing. 1992.. Inc. Drug Hand Book.B Lippincott Company. BIBLIOGRAPHY Pilliteri. :Essentials of Anatomy and Physiology. 2007. J.org/labornbirth/cesareanrisks http://www. Marilyn.1992.htm http://images. New York.ph . WEBSITES http://www. davis Company. 2003. Doyle.nih.: Nursing 2008. Doenges. Adele. F. Marieb. Lipppincott Williams & Wilkins. 5th edition. Elaine.nlm.XIV. Addison-Wesley Longman. Lippincott Williams & Wilkins. Martin. Lynda Juall.2008.: Minidictionary for Nurses. Oxford University Press. 4th edition. et al. 1.americanpregnancy.com. Vol. Elizabeth. 5th edition.