Surgical Cs Case Study_bang

8/12/2019 Surgical Cs Case Study_bang

1/25

A Case Study On

Cesarean Section

In Partial Fulfillment of the Course Requirement

In Medical Surgical Nursing

Submitted to

The Faculty of Cebu octor!s "ni#ersity

College of Nursing

Submitted by

$alde%anso& Mar' (loyd )*

$SN + , -


2/25

TABLE OF CONTENTS

I* Introduction

II* Ob.ecti#es

III* Nursing Assessment

/* Client!s 0ersonal history

/*/ Patient!s 0rofile

/*1 Family and indi#idual information& social and health history

/*2 (e#el of gro3th and de#elo0ment

/*2*/ Normal de#elo0ment at 0articular stage

/*2*1 The ill 0erson at 0articular stage of 0atient

1* iagnostic results

2* Profile of functional health 0atterns+* Patho0hysiology and rationale

+*/ 450lain the normal anatomy and 0hysiology of organ6system affected

+*1 Schematic dra3ing to sho3 0atho0hysiology of cesarean section 0rocess

+*2 Classical signs and sym0toms

I7* Nursing Inter#ention

/* Care guide of the 0atient 3ith 0ost Cesarean Section

1* Actual Patient Care

1*/ Assessment

1*1 Nursing Care Plan

1*2 $runs3ic' (ens Model

1*+ rug Thera0eutic Record

1*8 SOAPI4

1*9 :ealth Teaching Plan

7* 4#aluation and recommendation

7I* 4#aluation and im0lication of this case study

7II* Referral and follo3,u0

7III* $ibliogra0hy

1


3/25


4/25

II. OBJECTIVES

Student Nurse

)eneral Ob.ecti#es@

After 2 days of student nurse,client interaction& the student& 0atient and significant others

3ill be able to acquire 'no3ledge& 0ractice a00licable technique and de#elo0 a00ro0riate attitude

on the care of 0ost o0erati#e cesarean section*

S0ecific Ob.ecti#es@

At the end of this case study& the student nurse 3ill be able to@

/* relate 0atient!s 0ersonal history in terms of@

/*/ 0atient!s 0rofile/*1 family and indi#idual information& social and health history

/*2 le#el of gro3th and de#elo0ment

/*2*/ normal de#elo0ment at 0articular age

/*2*1 the ill 0erson at 0articular age of the 0atient

1* cite 0atient!s diagnostic results

2* discuss 0resent 0rofile of functional health 0atterns

+* re#ie3 the normal anatomy and 0hysiology of the organ or system affected

8* dra3 a schematic diagram of the cesarean section 0rocess

9* com0are the classical and clinical signs and sym0toms

* 0resent the nursing care 0lan formulated for the 0atient

Patient and Family

)eneral Ob.ecti#es@

After 2 days of holistic nursing care& the 0atient 3ill be able to gain 'no3ledge& s'ills and

attitude in the care of 0atient 3ho under3ent cesarean section


At the end of the student nurse,0atient interaction& the 0atient 3ill be able to@

/* establish ra00ort 3ith the student nurse

1* define cesarean section at the le#el of com0rehension

+


5/25

2* state 0ossible com0lication of 0ost,o0eration

+* demonstrate beginning s'ills in the management of 0ost cesarean section

8* relate im0ortance of follo3,u0 care

9* dis0lay 0ositi#e reaction on care gi#en by student,nurse

III. NURSING ASSESSMENT

1. Personal Hisor!

Paien"s Pro#ile

Name@ Mrs* Soltones& 4mmylou Amado

Age@ 2+

Se5@ Female

Ci#il Status@ Married

Religion@ Roman Catholic

ate of Admission@ Se0tember /2& 1B//

Com0laints@ Pain and s0otting

Im0ression6 iagnosis@ Re0eat lo3 segment trans#erse cesarean section 3ith

bilateral sal0ingectomy

Physician@ r* -oana (ourdes Singidas

Fa$il! an% in%i&i%'al in#or$aion( so)ial an% *eal* *isor!

This is a case of Mrs* Soltones& 4mmylou Amado& 2+ years old& married& a Roman

Catholic& (onoy San Isidro& $abay& (eyte 0ro#ince* The 0atient is not a 'no3n hy0ertensi#e or

diabetic but there is a history of hy0ertension in her 0aternal side of the family* She has no 'no3nallergies to food and drugs* The 0atient is a non,smo'er and an occasional alcoholic be#erage

drin'er* The 0atient 3as admitted at Cebu octor!s :os0ital emergency room*

8


6/25

1.+. Le&el o# Gro,* an% De&elo-$en

1.+.1 Nor$al %e&elo-$en a -ari)'lar sae

Physical Development

This #ie3 of the young adult begins 3ith an o#er#ie3 of the 0hysical status of men and

3omen during the 0rime of life* Issues of se5uality and fertility are co#ered along 3ith a

discussion of senescence and the 0rocess of gro3ing old,3hich begins almost im0erce0tibly

during young adulthood* They often e50erience ra0id& irregular 0hysical gro3th and undergo

bodily changes that may cause a3'3ard& uncoordinated mo#ements* :a#ing #arying maturity

rates& the girls tend to mature one and one,half to t3o years earlier than boys* The boys may be

at a disad#antage because of #aried rates of maturity that may require the understanding of

caring adults* They also e50erience restlessness and fatigue due to hormonal changes* Need

daily 0hysical acti#ity because of increased energy* e#elo0 se5ual a3areness that increases assecondary se5 characteristics begin to a00ear*

Physically they continue to gro3 and mature although the 0rocess slo3s do3n a little*

$oth men and 3omen usually sto0 the 0hysical maturation 0oint to become an adult at the end

of our young adult years and from there .ust gro3 older mentally and 0hysically 3hich of course

is a 0art of life but technology has made the aging 0rocess slo3er* uring young adulthood it is

also a time of e50loration* ;e find oursel#es able to en.oy life a little but more and e50erience

so much 3ithin this time that it can sha0e 3ho 3e are for the duration of our lifetime*

Psychosocial Development

Psychosocial Crisis@ Intimacy #s* Isolation

$ody and ego must be masters of organ modes and of the other nuclear conflicts in order to

face the fear of ego loss in situations 3hich call for self,abandon* The a#oidance of these

e50eriences leads to isolation and self,absor0tion* The counter0art of intimacy is distantiation&

3hich is the readiness to isolate and destroy forces and 0eo0le 3hose essence seems dangerous

to one=s o3n* No3 true genitality can fully de#elo0* The danger at this stage is isolation& 3hich

can lead to se#ere character 0roblems*Central Tas'@ Caregi#ing

Positi#e Outcome@ Form close relationshi0s and share 3ith others 4go Duality@ (o#e

efinition@ Ca0acity for mutuality that transcends childhood de0endency

e#elo0mental Tas'@ Stable relationshi0sE Child bearingE ;or' etc*

Significant Relations@ Marital 0artner& friends*

9


7/25

In young adult& they gradually begin to de#elo0abstract thin'ingthat is& the ability to

use internalsymbols or images to re0resent reality* In contrast to the more

childish concrete

thin'ing3here ob.ects ha#e to re0resentGthingsG or GideasG for sol#ing 0roblemsabstract

thin'ingenables us to thin' hy0othetically about the future and assess

multi0le outcomes*

Cognitive Development

Rational thin'ing habits increase steadily through the young adult and middle adult

years* Formal and informal educational e50eriences& general life e50eriences& and occu0ational

o00ortunities dramatically increase the indi#idual!s conce0tual& 0roblem,sol#ing& and motor

s'ills*

Identifying 0referred occu0ational areas is a ma.or tas' of young adults* ;hen 0eo0le

'no3 their s'ills& talents& and 0ersonality characteristics& educational 0re0aration& and

occu0ational choices are easier and more satisfying* Many young adults& ho3e#er& either lac'the resources or the su00ort systems to facilitate further education or the de#elo0ment of s'ills

necessary for many 0ositions in the 3or'0lace* As a result& some young adults may ha#e limited

occu0ational choices*

$ecause young adults are continually e#ol#ing and ad.usting to changes in the home&

3or'0lace& and 0ersonal li#es& their decision,ma'ing 0rocesses should be fle5ible* The more

secure young adults are in their roles& the more fle5ible and o0en they are to change* Insecure

0ersons tend to be more rigid in ma'ing decisions*

Moral Development

Occurring in young adulthood& 3e begin to share oursel#es more intimately 3ith others*

;e e50lore relationshi0s leading to3ard longer term commitments 3ith someone other than a

family member* Successful com0letion can lead to comfortable relationshi0s and a sense of

commitment& safety& and care 3ithin a relationshi0* A#oiding intimacy& fearing commitment and

relationshi0s can lead to isolation& loneliness& and sometimes de0ression* They are generally

idealistic& desiring to ma'e the 3orld a better 0lace and to become socially useful* Adults are in

transition from moral reasoning 3hich focuses on G3hat=s in it for meG to that 3hich considers

the feelings and rights of others* Often sho3 com0assion for those 3ho are do3ntrodden orsuffering and ha#e s0ecial concern for animals and the en#ironmental 0roblems that our 3orld

faces* Are mo#ing from acce0tance of adult moral .udgments to de#elo0ment of their o3n

0ersonal #aluesE ne#ertheless& they tend to embrace #alues consonant 3ith those of their 0arents*

Rely on 0arents and significant adults for ad#ice 3hen facing ma.or decisions* Increasingly

assess moral matters in shades of grey as o00osed to #ie3ing them in blac' and 3hite terms

characteristic of younger children* At times are quic' to see fla3s in others but slo3 to


8/25

ac'no3ledge their o3n faults* O3ing to their lac' of e50erience are often im0atient 3ith the

0ace of change& underestimating the difficulties in ma'ing desired social changes* Are ca0able of

and #alue direct e50erience in 0artici0atory democracy* )reatly need and are influenced by adult

role models 3ho 3ill listen to them and affirm their moral consciousness and actions as being

trust3orthy role models* Are increasingly a3are of and concerned about inconsistencies

bet3een #alues e5hibited by adults and the conditions they see in society

Spiritual Development

In Houng Adult 3e 3ould start at the 2rd

0eriod in s0iritual de#elo0ment and it is that

#ital 0hase 3hen the mind is being de#elo0ed& and the life is 0olari%ed in the mental body* The

man by no3 has full control of the 0hysical body& and each incarnation 0ro#ides better

equi0ment& 3ith the accent 0rimarily on the quality of the brain as the instrument of the mind*

Simultaneously the emotional body becomes more refined in its life of desire& and instead of asin the 0ast turning do3n3ards to the material for its satisfaction& it no3 tends u03ards& and

desire becomes transmuted into as0iration , at first mental as0iration& till later there comes an

a3areness of the e5istence of the sub.ecti#e 3orlds* The man also becomes conscious of the

.oys of the intellect& and therefore e#er stri#es for greater adequacy of the mind*

Mean3hile the di#ine s0ar' of the soul& 3hich for so long has remained dormant& has

commenced to glo3 and to de#elo0 into a small flame* This s0iritual fire is 0ermeating the body

of the soul& su00lying it 3ith 3armth& radiating its energies& and allo3ing the soul to gain in

consciousness on its o3n 0lane* The 0hysical brain& ho3e#er& does not yet become consciously

a3are of im0ressions issuing from this ind3elling force*

1.+./ Ill -erson a -ari)'lar sae

The young adult years are generally a time of good 0hysical and emotional health*

Potential health ha%ards may be related to lifestyle* Acute care for young adults is frequently

related to accidents& substance abuse& e50osure to en#ironmental and occu0ational ha%ards&

stress,related illnesses& res0iratory infections& gastroenteritis& influen%a& urinary tract infections&

and minor surgery* An acute minor illness can cause a disru0tion in life acti#ities of the youngadult and increase stress in an already hectic lifestyle* e0endency and limitations 0osed by

treatment regimens can also increase frustration for the young adult* To gi#e young adults a

sense of maintaining control o#er their health care choices& it is im0ortant to 'ee0 them

informed about their health status and in#ol#e them in health care decisions*


9/25

/. Dianosi) Res'ls

Dianosi) Tes Nor$al Val'es Res'l Sini#i)an)e

Co$-lee Bloo% Co'n

0CBC February /& 1B/B

:ematocrit

:emoglobin

R$C

;$C

(ym0hocyte

Monocyte

Platelet

MC:MC7

MC:C

HBsA 02'ali

Bloo% T!-in

Ulraso'n%

2,+ #ol 1*1 0ounds?*

4./ S)*e$ai) %ra,in o s*o, -a*o-*!siolo! o# )esarean se)ion -ro)ess

PREDISPOSING FACTORS, Prolonged or arrested labor, 7ery large baby >macrosomia?, Ce0halo0el#ic dis0ro0ortion >baby=s

head is too large to 0ass throughmother=s 0el#is?

, "mbilical cord 0rola0se >the umbilicalcord comes through the cer#i5?

, Placenta attached in abnormal location>0lacenta 0re#ia?

, Prematurely se0arated from uterine3all >0lacenta abru0tio?

PR4CIPITATIN) FACTORS

, 45treme maternal illness& such as heartdisease& to5emia&0reeclam0siaoreclam0sia

, Acti#e genital her0es infection

, Maternal :I7 infection

, Pre#ious surgery in the uterus& including

myomectomy and 0re#ious C,sections

/1

Ele)i&e )esarean se)ion

%eli&er! o# a 7a7! *ro'* as'ri)al a7%o$inal in)ision

S'rer! is %one ,*ile *e ,o$an is a,a8e 7' anes*ei9e%#ro$ *e )*es o *e les 7! e-i%'ral or s-inal anes*esia.An in)ision is $a%e a)ross *e a7%o$en :'s a7o&e *e-'7i) area. T*e 'er's is o-ene%( *e a$nioi) #l'i% is%raine%( an% *e 7a7! is %eli&ere%

T*e 7a7!;s $o'* an% nose are )leare% o# #l'i%s( an% *e'$7ili)al )or% is )la$-e% an% )'. T*e 7a7! is *an%e%

o *e n'rse ,*o ,ill $a8e s're *a 7rea*in isnor$al.
http://www.nlm.nih.gov/medlineplus/ency/article/000898.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000899.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000899.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000898.htm


13/25


14/25

1. Care 'i%e o# -aien ,i* -os Cesarean Se)ion

A* Pro#ide 0ain relief for after 0ains

;oman can be assured that this discomfort is normal and rarely last more than 2 days* If

necessary& an analgesic s0ecific for relief of after 0ains that reduces inflammation& or a commonanalgesic can be ta'en for relief >as 0rescribed by the 0hysician?* As 3ith any abdominal 0ain& heat

should not be 0laced on the abdominal area* This could cause rela5ation of the uterus and

consequent uterine bleeding*

$* Monitor 7ital Signs

The 0atient is no3 e#aluated at least hourly for + hours at the minimum& and blood

0ressure& 0ulse rate& res0iratory rate& urine flo3& amount of bleeding and status of the uterine

fundus are chec'ed at these times* Therefore& for the first 1+ hours& these are chec'ed at inter#al

of + hours& along 3ith the tem0erature*

C* Fluid thera0y and diet

(arge #olumes of intra#enous fluids during and subsequent to surgery are not needed to

re0lace sequestered e5tra cellular fluid* As a generali%ation 2l of fluid should 0ro#e adequate

during the first 1+ hours after surgery* In the absence of e5tensi#e intra,abdominal mani0ulation

or se0sis& the 3oman nearly al3ays should be able to tolerate oral fluids or e#en a regular diet the

day after surgery* $y the second day after surgery& the ma.ority of 3omen tolerate a general diet*

* $ladder and bo3el training

The bladder catheter most often can be remo#ed by /1 hours after o0eration or more

con#eniently& the morning after surgery* $o3el sounds may be hy0oacti#e the day after surgery&

but are usually normal by the third day* )as 0ains from in coordinate bo3el action maybe

troublesome the second and third 0ost,o0erati#e days* Frequently a rectal su00ository 0ro#ides

a00reciable relief*

4* 4ncourage ambulation

In most instances& by the day after surgery the 0atient& 3ith assistance& should get out of

bed briefly at least t3ice* Ambulation can be timed so that a recently administered analgesic 3ill

minimi%e the discomfort* $y the second day she may 3al' to the bathroom 3ith assistance* ;ith

early ambulation& #enous thrombosis and 0ulmonary embolism are uncommon*

F* ;ound care

/+


15/25

The incision is ins0ected each day& and the s'in sutures are remo#ed on the fourth day

after surgery* $y the third 0ost,0artum day& bathing by sho3er is not harmful to the incision*

)* Pro#ide 0erineal care

Perineal care should be underta'en as a 0art of the daily bath and after each #oiding or

bo3el mo#ement* If a 3oman is on bed rest during the first hour after birth you 3ill need to

0ro#ide 0erineal care for her* As soon as she is ambulatory& she can be instructed to carry it out

herself* 4#ery 3oman needs attention to 0erineal cleanliness in the 0ost,0artal to 0re#ent

infection& as lochia allo3ed to dry and harden on the #ul#a and 0erineum furnish a bed for

bacterial gro3th* $ecause the #agina lies in close 0ro5imity to the rectum& there is al3ays the

danger that bacteria 3ill s0read from the rectum to the #agina and cause uterine infection*

:* (aboratoryThe hematocrit is routinely measured the day after surgery* It is chec'ed sooner 3hen

there 3as unusual blood loss or 3hen there is oliguria or other e#idence to suggest hy0o#olema*

If the hematocrit is decreased significantly from the 0reo0erati#e le#el& it is re0eated and search is

indtituted to identify the cause of the decrease* IF the lo3er hematocrit is stable& the mother can

ambulate 3ithout any difficulty& and if there is little li'elihood of further blood loss&

hematologicical re0air in res0onse to iron thera0y is 0referred to transfusion*

I* Promote rest in early 0ost,0artum 0eriod

Follo3ing a first get acquainted meeting 3ith the infant& the 3oman should be encouraged

to slee0 to counteract the deficit from slee0 lost during labor* All the 0rocedures that must be

carried out 3ith her >blood 0ressure& 0ulse& fundal height chec'ing and 0erineal ins0ection? should

be done s3iftly and gently to allo3 her as much slee0 as 0ossible*

-* Alle#iate breast engorgement

If the 3oman is breast feeding& the suc'ing of the infant is the main treatment for relief of

the tenderness and soreness of 0rimary breast engorgement* In addition& the 3oman needs a firm&

su00orting bra to eliminate a tugging sensation and 0ossibly a medication such as synthetico5ytocin nasal s0ray used .ust 0rior to breast feeding* The nasal s0ray is absorbed in the mucous

membrane of the nose and hel0s bring mil' for3ard in the breast ducts& reducing engorgement*

She may find a00lication of hot or cold com0resses or standing under a hot sho3er beneficial*

* Promote breast hygiene

/8


16/25

The 3oman should 3ash her breast daily at the time of her bath and sho3er and should not

use soa0 on her breast& because soa0 tends to dry and crac's ni00les* This could lead to fissures and

0ossible discharge of colostrum or mil' from her breast should insert clean gau%e squares or

commercial 0ads in her bra to absorb the moisture* These should be change as often as necessary to

'ee0 the ni00le dry* If ni00les remain 3et for any length of time& fissures may form and lead to

infection*

/. A)'al Paien Care

/.1 Assess$en

BOD< PARTS INSPECTION PALPATION PERCUSSION AUSCULTATION

:4A

:AIR

SCA(P

FAC4

FOR4:4A

4H4S

4H4$RO;S

4H4(AS:4S

CORN4A

, normoce0halic

, long >shoulder

length? blac'& thin&shiny

, 0resence ofnatural oil andabsence of dandruff

, slight 0im0les&oily s'in

, 0resence of small

0im0les

, both eyes aresymmetrical& 0alecon.ucti#a& able to#isuali%e clearly

, blac'&symmetrical&hair e#enly

distributed, blac'& short& hairis e#enlydistributed

, trans0arent&clear

, 3hite in color

, no lesion

, notenderness

, no lum0s&lesions& no0ain felt

, notenderness

/9


17/25

SC(4RA

IRIS

P"PI(S

4ARS

NOS4

SIN"S4S

S4PT"M

MO"T:

(IPS

)"MS

"7"(A

TONSI(S

TON)"4

N4C

(HMP: NO4S

SIN

, dar' bro3n incolor

, equally round and

reacti#e to lightand accomodation

, symmetricallobes& goodauditory acuity

, located medially

, clear& not

congested

, midline

, no #isible lesions&moist

, full& dry li0s

, 0in'ish& moist

, centrally located&0in'ish

, not inflamed

, mo#es freely&centrally located

, able to mo#efreely& small moles0resent

, not enlarged

, light bro3n& no0resence of bruises&good turgor

, short& trimmed

, notenderness

, no 0ain feltu0on0al0ation

, no 0ain felt&no scars orlum0s

, no lum0s

, no 0ain feltu0on 0ercussion

, no 0ain feltu0on 0ercussion

/


18/25

NAI(S

C:4ST

$R4AST

:4ART

("N)S

A$OM4N

4TR4MITI4S"PP4R

(O;4R

, 0ositi#e rise andfall

, engorged& ni00lesnot in#erted&dar'ened areola

, 11 breaths 0erminute

, surgical incision

0resent& globular&dressing intact

, com0lete set offingers& strong&3ith I7 at righthand 8(R Q 2Bgtts6min 3ith 1Bunits O5ytocin

, com0lete set oftoes& trimmed andshort toe nails&strong

, ca0illaryrefill is lessthan 1 secs

, no 0ain feltu0on0ercussion

, tender& slight0ain felt u0onlight 0al0ation

, PRJ

,resonant sound

, no murmurs

, :R9 b0m

, normal breathsounds

, $P/1B6B

/


19/25

/.= SOAPIE

Name of Patient@ Mrs* )oo0io& $eny ate@ February /& 1B/Biagnosis@ Pregnancy "terine Full Term

SOAPIE >1

S KSa'it gyud siya inig liho' na'o*L as #erbali%ed by the 0atient*

O A fe3 hours 0ost,cesarean deli#ery 3ith radiating 0ain from abdominal area to3ards thebac' or 0osterior as0ect of the trun' for 2, minutes 3ith a rate of 3ithin B,/B scale&facial grimace and guarded mo#ements noted u0on ambulation*

A Alteration in comfort@ Pain related to tissue trauma and bro'en s'in sustained during surgery*

P Patient 3ill be able to e50erience 0ain at a minimal le#el*

I Promoted dee0 breathing e5ercisesE 4ncouraged di#ersional acti#ities li'e sociali%ation&reading a maga%ine and listening to musicE Placed 0atient in semi,fo3lers 0ositionE Taught0atient to su00ort incision 3hen mo#ingE Pro#ided comfort measures li'e bac' rubbing*

E KNaa 0a man ang sa'it 0ero tan,a3on lang ni n'o*L as #erbali%ed by the 0atient*

Name of Patient@ Mrs* )oo0io& $eny ate@ February /& 1B/Biagnosis@ Pregnancy "terine Full Term

/J


20/25


21/25

OBJECTIVES CONTENT METHODOLOG< EVALUATION

)eneral Ob.ecti#es@

After 1 days ofstudent nurse,0atient interaction&the 0atient 3ill beable to aquire'no3ledge&attitude& and s'illsin regaining normalbody function*


After 2B , +8minutes of nurse,0atient interaction&the 0atient 3ill beable to@

/* identify anddifferentiate ty0esof cesareansection

1* discuss theim0ortance of@

1*/ breathinge5ercises

1*1 early ambulation

/* cesarean deli#ery, method of deli#ery by abdominaland uterine incisions*Ty0es of Cesarean@

a* Classicalb* Trans#erse

1*/* im0ortance of breathinge5ercises

a* 450and colla0se lungb* Pre#ent 0ost,o0erati#e

0neumonia and atelectasis

c* c* Reduce se#erity of 0ain

1*1 im0ortance of earlyambulation

a* mother 3ill feel better andstronger

b* Im0ro#ed bladder and

(ecture discussion

(ecture discussion

(ecture discussion

Patient 3as ableto identifyaccording to hero3n le#el of

understanding*

1/


22/25

1*2 good and0ro0er nutrition

1*+ breast feeding

2*demonstratebeginning s'ills in@

2*/ breathinge5ercises

2*1 breast care

bo3el functionsc* abdominal distention and

consti0ation occurs lessfrequently

d* fe3er com0lications of

thrombo0hlebitise* stimulates circulation

1*2 im0ortance of good and0ro0er nutrition

a* to meet daily dietaryallo3ance

b* to regain strength0re#ent susce0tibility toinfection and diseases

1*+ im0ortance of breast feeding

a* Considered to be thesu0erior source ofnutrition

b* 0romotes bonding bet3eenmother and child

c* 0ro#ides maternalantibodies to 0re#entinfection

2*/ beginning s'ills in breathinge5ercises

a* sit on the edge of the bedor su0ine 3ith legs fle5edto rela5 abdominal muscle

b* 0lace hands on abdomenc* inhale thru nose until

abdomen balloons out3ardd* e5hale through the li0s

3hile contractingabdominal area

2*1 beginning s'ills in breast carea* soa' cotton in sterile 3aterb* clean from the inner area

to3ards the outer area inrotating motion

c* do not use alcohol incleaning the ni00le

(ecture discussion

(ecture discussion

(ecture discussionand demonstration


11


23/25

2*2 breast feeding2*2 beginning s'ills in breastfeeding

a* find a comfortable 0lace tosit or lie and rela5

b* hold and offer the 3holebreast* o not 0inch theni00le and areola

c* Tic'le the baby!s chee' tostimulate suc'ing


12


24/25

V. EVALUATION AND RECOMMENDATION

On the first day of interaction the client tried her best to be attenti#e and coo0erate 3ith

the student nurse des0ite the 0ost,o0erati#e 0ain& so ra00ort 3as 3ell establish* Nursinginter#entions 3ere im0lemented to alle#iate 0hysiological disturbances of the client* The client

3as not hesitant to the acti#ities but instead sho3ed 3illingness to the care regimen according to

her ca0abilities* Im0lementation of health teaching such as dee0 breathing e5ercises& good and

0ro0er nutrition& ambulation and breast care 3ere im0arted* Promotion of 0ositi#e out loo' 3as

0romoted*

Nursing care measures such as breast care& correct breast feeding technique and bur0ing

should be continued at home*

VI. EVALUATION AND IMPLICATION OF THIS STUD< TO6

A. N'rsin Pra)i)e

This case study hel0s the nursing students in utili%ing the nursing 0rocess and acquires

'no3ledge& attitude and s'ills in gi#ing holistic care to the client* It has also equi00ed the nursing

student a good 3or'ing relationshi0 of not only Maternal,Child Nursing but Medical,Surgical

Nursing as 3ell& and has im0ro#ed the attitude and s'ills in gi#ing care to the 0ost,cesarean

3oman*

B. N'rsin E%')aion

This case study doesn!t only gi#e a broadened 'no3ledge in 0articular case but also the

entire series of nursing care& therefore im0ro#ing s'ills and educating the nursing student 3ith

ne3 inter#ention in gi#ing ne3 holistic care to client* This 3ould also hel0 the student nurse

e50erience his learned 'no3ledge and a00reciate the s0ecial s'ills 3hich 3ould contribute to case

of 0ost,cesarean 3omen*

C. N'rsin Resear)*

Nursing research is dynamic therefore it is al3ays o0en to ne3 inter#ention* ;hat the

student nurse gathered in this case maybe added u0 to the nursing 0rocess 3hich 3ould be of

great hel0 in holistic care to 0ost,cesarean client!s and not to be used as research material*

1+


25/25

Documents

Surgical Cs Case Study_bang