Postpartum Care for C-section Patient

Postpartum Care for C-section Patient

Introduction

Caring for a C-Section patient requires elaborate planning and attention. The action is vital in enabling the individual to have the ease of recuperation from the operation. It promotes the rate of healing of the wound while at the same time, minimizing the chances of worsening of the condition. Also, being a mother to a newborn, the woman needs to feel appreciated and valued. The action is essential in enabling her to attain both physical and psychological capability to attend to her newborn. As a result, it is possible to improve the welfare of the baby. This case study highlights the situation of a 26-year-old who has just undergone a C-Section procedure and, therefore, needs to be cared for.

Patient Assessment

The patient is a 26-year old female. She has G₁ P₁. She had 40 weeks breach of labor. There was the supervision of normal intrauterine muprocess in primifrovida. There was a breech presentation. The baby was delivered, and the patient is currently hospitalized. Her blood type is A+. She tested negative for chlamydia and gonorrhea. She tested positive for GPS. She also tested negative for Hepatitis B and HIV. She is also rubella immune. In regards to her vitals, her BP is 126/74. Her P was 72, her R, 22 her T_o 37.2 while her SPO₂ was 100.  The lab results show that her WBC is 16.7, RBC is 3.26, Hgb is 10.1, her HCT is 25.0, her neutrophil level is 83.6, and her platelet count is 87. The weight of the patient is 79.8 Kgs; her height is 148 cm, while her BMI is 36.14.

In regards to her integumentary, her skin is intact and dry. Her breast is soft, and her nipples are soft. She is lactating, and the baby is feeding with ease.

In regards to medication, she is currently taking azithromycin 500 mg  IV 2 doses, Toradol PRN, Motrim every 6 hours and oxytoclone.

Pathophysiology of Disease Process

Hypertension is identified to be present in cases where the blood pressure is at least 140/90 mm Hg. The disease is characterized by increased vascular resistance, increased vascular responsiveness, and increased vascular stiffness. Therefore, the pressure of the blood exerts excessive force on the various blood vessels. The blood vessels lack the ability to withstand the pressure of the blood and might lose their tensile strength. The continuity of hypertension exposes people to other morbidity elements such as heart failure of heart disease. It also creates a risk for the development of other health problems such as diabetes. As a result, it exposes people to the risk of death, especially in cases where the blood pressure levels are higher than normal. The signs and symptoms of hypertension include; severe headache, chest pains, difficulty in breathing, pounding in the chest, and neck and vision problems.

Nursing Diagnoses of the Patient

An assessment of the patient shows that she is recuperating well, following the C-section. It is, however, noted that her blood pressure is high, and there is a case of pre-hypertension. Furthermore, it is established that the patient is obese, which could be a contributing factor to hypertension, other than the pregnancy. Since the patient is determined to be overweight, that could be deemed to be the cause for hypertension, alongside other factors such as the intake of diets rich in saturated fats and processed sugars. The situation leads to a build-up of large amounts of fat deposits in the body. Eventually, the deposits lead to the constriction of the inner walls of blood vessels. As a result, they increase upon the blood pressure in the vessels. The sustained increase in blood pressure, thereby, increases upon the risk of development of hypertension.

Nursing Diagnoses, Goals of Care and Nursing Interventions

The two nursing diagnoses used on the patient entails assessing her blood pressure levels and her BMI. These diagnoses will be appropriate in helping to show the health situation of the patient and ensure that the necessary improvements are adopted in line with boosting their health outcomes appropriately. The goals of assessing the blood pressure will be to establish whether the patient is recuperating and to determine the kind of treatment which they might need. The purpose of determining the BMI of the patient will be to establish the dietary and exercise recommendations which might be provided to the client and to decide whether or not it serves the risk of influencing the continued development of hypertension on the patient.

One nursing intervention is to maintain cleanliness to ensure that the patient is protected from any potential infections which she might contract at the health facility (Yang et al., 2018). The strategy will be essential in boosting the quality of health of the patient and enable her to attain the capability to take proper care of her child. The second nursing intervention will entail giving the patient Angiotensin II receptor blockers to stabilize her and ensure that she is in the right condition (Chiodini & Morelli, 2016).  A third nursing intervention will be to educate the patient and her caregivers on the exercise and diet improvements to take. The strategy will be essential in improving her health condition by reducing her weight so her BMI could be normal. The action will be crucial in reducing the rate of development of hypertension.

The outcome is that the blood pressure level of the patient will reduce significantly. As a result, the patient will attain normalcy.

How I Will Start the Care Plan

I will start the care plan by informing the patient that her C-Section operation was successful, and the wound is healing. I will, however, inform her that it is necessary to improve her weight to ensure that she does not face the risk of having full-blown hypertension. I will tell her that it is necessary to consider taking foods that are rich in processed sugars and saturated fats. I will also inform her of the need to ensure that she undertakes regular exercise. The action will be essential in improving her health by reducing her health. As a result, she will have a lower chance of having hypertension. I will initiate the care plan by providing the patient with Angiotensin II receptor blockers to slow down the rate of development of pre-hypertension.

How to Determine if the Goals of the Nursing Care Plan and the Outcomes Have Been Met

Where it is established that the blood pressure of the patient has stabilized at less than 120/80 mm/hg. The action will show that the health of the patient is improving, and the chances of developing hypertension have reduced significantly (Markabayeva et al., 2018). Also, a reduction in weight and BMI of the patient will show that the nursing goals are being attained. The BMI will need to be between 18.5 and 24.5.

Summary

The 26-year-old has just undergone a C-section where a healthy baby was delivered. Her vitals show that she is well. Her operation was also successful. However, she is obese and has pre-hypertension. Thus, it is necessary to administer the Angiotensin II receptor blockers. The nurse also needs to advise the patient on the importance of having regular exercise and avoid foods that are rich in processed sugars and saturated fats. Where the hypertensive levels of the patient reduce, the intervention will have worked out well.

References

Chiodini, I., & Morelli, V. (2016). Subclinical hypercortisolism: how to deal with it?. In Cortisol Excess and Insufficiency (Vol. 46, pp. 28-38). Karger Publishers.

Markabayeva, A., Bauer, S., Pivina, L., Bjørklund, G., Chirumbolo, S., Kerimkulova, A., … & Belikhina, T. (2018). Increased prevalence of essential hypertension in areas previously exposed to fallout due to nuclear weapons testing at the Semipalatinsk Test Site, Kazakhstan. Environmental research, 167, 129-135.

Yang, S., Chen, J., Shen, Y. M., Wang, M. G., Cao, J. X., & Liu, Y. C. (2018). Retrospective research on initiative content reduction technique for obesity patients with huge abdominal incisional hernia. International Journal of Abdominal Wall and Hernia Surgery, 1(1), 19.