post op and wound healing
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- Created by: Ruby waterhouse
- Created on: 17-01-21 08:51
implications of surgery
- may create personal stress was it the birth she wanted?
- family stress
- cause frustration, fear
- longer stay in hospital
- family stress
- cause frustration, fear
- longer stay in hospital
1 of 30
what routine care is carried out by the midwife after the surgery
- one to one care provided
- MEOWS chart completed
- observations done clearly and regularly - RR,HR,BP pain scores
- MEOWS chart completed
- observations done clearly and regularly - RR,HR,BP pain scores
2 of 30
frequency of observations depends on type of analgesia eg
irathecal opioids ?
irathecal opioids ?
- a min of hourly observations of RR, sedation and pain scores for at least 12 hours for diamorphine and 24 hours for morphine
3 of 30
frequency of observations depends on type of analgesia eg
epidural or patient controlled analgesia with opioids ?
epidural or patient controlled analgesia with opioids ?
- routine hourly monitoring of RR, sedation, pain scored throughout the treatment and at least 2 hours after discontinue of treatment
4 of 30
what to monitor after the op and why
x5
x5
- PV loss - check for PPH
- bladder care - complete fluid balance chart - can be poor after surgery due to dehydration
- wound care - should remain dry pressure dressing may be needed
- comfort, hygiene, dignity
- bladder care - complete fluid balance chart - can be poor after surgery due to dehydration
- wound care - should remain dry pressure dressing may be needed
- comfort, hygiene, dignity
5 of 30
what to monitor after the op and why
x2
x2
- drain - check for blood loss coming out of the drain and document on fluid balance chart
- cannula - stays in until woman has mobilised blood loss is normal however if it is high bloods may need to be taken to check for iron
- cannula - stays in until woman has mobilised blood loss is normal however if it is high bloods may need to be taken to check for iron
6 of 30
how pain can be manged after the surgery
(trust dependent)
(trust dependent)
- paracetamol, ibuprofen, oramorph, dihydrocodeine
7 of 30
what should be taken into consideration before giving medications?
- check what medications have been given in theatre eg paracetamol to check what medications the woman is then able to have
eg id diclofenac is given in theatre, no ibuprofen for 16-18 hours
eg id diclofenac is given in theatre, no ibuprofen for 16-18 hours
8 of 30
why should non steroidal anti inflammatory drugs be given post CS as a supplement to other analgesics?
- because they reduce the need for opioids
9 of 30
eating and drinking after c section
- women who are recovering well and do not have any complications can eat and drink as normal
- however may women can have nausea which will then need antiemetics prescribed
- monitor input, intravenous infusion, fluid balance chart and special diets eg
- however may women can have nausea which will then need antiemetics prescribed
- monitor input, intravenous infusion, fluid balance chart and special diets eg
10 of 30
mobilisation after c section
what does this depend on?
what does this depend on?
- this depends on the procedure and the woman
- elective cs - speedy recovery remove canula and catheter and assist from bed after 6 hours
- emergency cs and 3/4th degree tear - can be slower to mobilise but should be within 12 hours after op
- elective cs - speedy recovery remove canula and catheter and assist from bed after 6 hours
- emergency cs and 3/4th degree tear - can be slower to mobilise but should be within 12 hours after op
11 of 30
what information should be given to the woman post sc?
- what analgesia they are on and when is it next due?
- where the call bell is
- what to expect - when they have the catheter and cannula out, when they can mobilise, go home and when can the dressing come off
- provide relevant leaflets
- where the call bell is
- what to expect - when they have the catheter and cannula out, when they can mobilise, go home and when can the dressing come off
- provide relevant leaflets
12 of 30
what should be done about the baby after surgery ?
- encourage skin to skin
- assist with infant feeding
- discuss safety issues / safe sleeping ect
- assist with infant feeding
- discuss safety issues / safe sleeping ect
13 of 30
what should be documented post c section?
- MEOWS
- fluid balance
- risk assessments
- catheter and canula removal
- medications
- other advice that has been given
- fluid balance
- risk assessments
- catheter and canula removal
- medications
- other advice that has been given
14 of 30
what are the 4 phases of wound healing?
- hemostatis day 1-2 - stop the bleeding
- inflammation 3-20 - new framework for blood vessel growth
- proliferation week 1-6- pulls the wound closed
- remodelling of maturation week 6 to 2 years- final proper tissue
- inflammation 3-20 - new framework for blood vessel growth
- proliferation week 1-6- pulls the wound closed
- remodelling of maturation week 6 to 2 years- final proper tissue
15 of 30
c section wound dressing
when should it be removed ?
how long does it stay on for?
when should it be removed ?
how long does it stay on for?
- type of dressing may vary but most stay of until day 5 postnatal
- should be removed earlier if it is oozing or leaking
- should be removed earlier if it is oozing or leaking
16 of 30
what should be considered when doing wound assessment ?
- type of wound
- location
- nature of the pain - what is it like?
- visible leakage - how saturated the dressing is on removal
- offensive smell? any signs of infection?
- location
- nature of the pain - what is it like?
- visible leakage - how saturated the dressing is on removal
- offensive smell? any signs of infection?
17 of 30
signs of a possible c section wound infection
- offensive abnormal smell
- unexpected pain or tenderness
- pus
- delayed normal healing
- discharge from wound
- discolouration of wound bed eg beefy red/ dull purple
- unexpected pain or tenderness
- pus
- delayed normal healing
- discharge from wound
- discolouration of wound bed eg beefy red/ dull purple
18 of 30
infection
- early diagnosis and treatment is essential to minimise the risk of more serious compilations
- the development of new pain or change in the existing pain is an indicator of a wound infection
- the development of new pain or change in the existing pain is an indicator of a wound infection
19 of 30
factors that can affect wound healing
- raised BMI
- medical conditions such as diabetes
- poor hygiene
- maternal age
- infection
- sepsis
- diet
- medical conditions such as diabetes
- poor hygiene
- maternal age
- infection
- sepsis
- diet
20 of 30
wound healing and raised BMI what can this cause?
what may need to be done in this situation?
what may need to be done in this situation?
-fat tissue can hang over the womb and cause excessive moisture
-pico negative wound therapy - dressing connected to a pump which takes excess fluid out
-pico negative wound therapy - dressing connected to a pump which takes excess fluid out
21 of 30
how can maternal age affect wound healing?
- healing processed can be slowed with age
22 of 30
infection how can this affect wound healing and what can it go on to cause ?
- can cause infection and then go on to cause sepsis
23 of 30
how can diet affect wound healing?
- good diet provides vitamins and nutrients to help with the healing process
24 of 30
how can smoking affect wound healing?
- reduces the amount of oxygen getting to the tissues which then goes on to slow the process down
25 of 30
indications that a woman may need a catheter
- prior to surgery
- if unable to pass urine
- inability to pass urine postnatally - trauma
- prior to instrumental delivery
- during 3rd stage of labour
- if unable to pass urine
- inability to pass urine postnatally - trauma
- prior to instrumental delivery
- during 3rd stage of labour
26 of 30
equipment needed
- appropriate catheter
- PPE
- anaesthetic gel
- normal saline
- PPE
- anaesthetic gel
- normal saline
27 of 30
what to consider when carrying out the
procedure
procedure
- gain consent
- remember it is a sterile procedure
- obtain equipment
- follow ANTT
- ensure the woman is in a comfortable position - semi recumbent ankles together
- ensure dignity
- document
- remember it is a sterile procedure
- obtain equipment
- follow ANTT
- ensure the woman is in a comfortable position - semi recumbent ankles together
- ensure dignity
- document
28 of 30
how to reduce infection
- ANTT
- appropriate catheter care
- drainage bag at the appropriate level
- trained and up to date staff
- appropriate catheter care
- drainage bag at the appropriate level
- trained and up to date staff
29 of 30
structural changes in the bladder throughout pregnancy
descent of fetal head causes compression on bladder
- analgesia eg epidural can cause decreased awareness to pass urine as they temp block
nerves to the bladder
- analgesia eg epidural can cause decreased awareness to pass urine as they temp block
nerves to the bladder
30 of 30
Other cards in this set
Card 2
Front
what routine care is carried out by the midwife after the surgery
Back
- one to one care provided
- MEOWS chart completed
- observations done clearly and regularly - RR,HR,BP pain scores
- MEOWS chart completed
- observations done clearly and regularly - RR,HR,BP pain scores
Card 3
Front
frequency of observations depends on type of analgesia eg
irathecal opioids ?
irathecal opioids ?
Back
Card 4
Front
frequency of observations depends on type of analgesia eg
epidural or patient controlled analgesia with opioids ?
epidural or patient controlled analgesia with opioids ?
Back
Card 5
Front
what to monitor after the op and why
x5
x5
Back
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