Cesarean birth, also termed cesarean section, is the delivery of a neonate by surgical incision through the abdomen and uterus. The term cesarean birth is used in nursing literature rather than cesarean delivery to accentuate that it is a process of birth rather than a surgical procedure. This method may occur under planned, unplanned, or emergency conditions. Indications for cesarean birth may include abnormal labor, cephalopelvic disproportion, gestational hypertension or diabetes mellitus, active maternal herpes virus infection, fetal compromise, placenta previa, or abruptio placentae.
Nursing Care Plans
Cesarean section is currently the most common major surgical procedure in the United States. However, it carries risks to both the mother and the fetus. It also has a lengthy recovery period than vaginal birth. Some women may have difficulty attempting a vaginal birth later. Yet, many women can have a vaginal birth after a cesarean (VBAC). Hence, mothers need to work with health care providers to make the best decision for themselves and the baby.
- Deficient Knowledge UPDATED!
- Acute Pain UPDATED!
- Risk for Infection UPDATED!
- Risk for Deficient Fluid Volume UPDATED!
- Risk for Disturbed Maternal-Fetal Dyad UPDATED!
- Risk for Injury UPDATED!
- Anxiety or Fear UPDATED!
- Risk for Situational Low Self-Esteem UPDATED!
- Powerlessness UPDATED!
- Risk for Ineffective Self Health Management UPDATED!
- Risk for Impaired Parenting UPDATED!
Risk for Ineffective Self Health Management
The postpartum period is a difficult time, where new roles and responsibilities are assumed. During this period, the parents have to learn infant care, establish a safe environment for the infant, learn the new roles, and deal with the problems related to the infant. However, the postpartum period is also when the mother needs the most information, support, and qualitative care. Being discharged from the facility 24 hours after birth may be sufficient to prevent complications; however, it is not sufficient enough to support the mother to adapt to her new situation. Therefore, at such a critical period, the mother’s physical and mental health should be closely monitored after the discharge (Capik et al., 2015).
- Risk for Ineffective Self Health Management
Risk factors may include
- Ineffective individual coping
- Complex therapeutic regimen
- Conflicts with spiritual values or cultural influences
- Psychological stress
Possibly evidenced by
A risk diagnosis is not evidenced by signs and symptoms, the presence of signs and symptoms establishes an actual/problem diagnosis. Nursing interventions are directed at prevention.
Desired outcomes and goals
- The client participates in the development of goals and care plans.
- The client demonstrates behaviors necessary to incorporate a therapeutic regimen in daily life.
- The client verbalizes understanding of the therapeutic regimen.
- The client verbalized acceptance of changing actions to achieve desired outcomes.
Nursing Assessment and Rationales
1. Assess the environment for factors causing sensory overload.
Cesarean birth can be tedious to the client, and she may not concentrate on the procedures being performed. Determine the factors that can be controlled and cannot be controlled.
2. Assess the extent of the client’s ability to move in bed and breastfeed.
Explain the importance of getting out of bed and caring for the neonate. Early ambulation helps prevent thrombophlebitis, and early breastfeeding helps establish an adequate milk supply.
3. Assess the client’s and partner’s ability to comprehend information, including literacy, level of education, and primary language.
This provides opportunities to clarify viewpoints or misconceptions. It also verifies that the client and her partner have accurate and factual information to make informed choices. The prenatal and postpartum periods are needed to prepare the woman and family adequately for recovery and parenting (Miovech et al., 2013).
4. Determine cultural, spiritual, and health beliefs and ethical concerns.
Identifying these factors provides insight into thoughts and factors related to individual situations. Beliefs will affect the client’s perception of the situation and participation in the therapeutic regimen. Interventions may be incongruent with the client’s social and cultural lifestyle and perceived role/responsibilities.
Nursing Interventions and Rationales
1. Provide the client information about the cesarean birth postpartum care.
Information about postpartum care and how to manage possible complications can help decrease anxiety and put perceived “chaos” in perspective. An unplanned, emergency cesarean delivery can be especially stressful, with its unfamiliar and intrusive procedures occurring in rapid succession, straining the ability of the mother to assimilate the experience (Miovech et al., 2013). Providing information helps prepare the women for a new life, decreases maternal morbidity during this period, and promotes recovery (Salam Ramadan & Farrag, 2018).
2. Explain the physiological process of the woman during the postpartum period.
Explanations about the process of returning to the nonpregnant state should be provided at this time by the nurse. Women need to learn that the discomfort associated with the healing incision may take months to resolve. The ability to move quickly and easily will return gradually. Methods to accomplish teaching can include pamphlets, videos in the postpartum unit, and postpartum follow-up calls (Miovech et al., 2013).
3. Listen to the client’s and partner’s reports and comments.
Listening actively conveys a message of concern and belief in the individual’s capabilities to resolve the situation positively. Each interaction with the postpartum woman should have specific teaching and learning goals because often the woman will be discharged according to externally applied criteria rather than personal readiness (Miovech et al., 2013).
4. Provide positive reinforcements for efforts.
Positive feedback encourages the continuation of the desired behaviors. Emphasize positive aspects of the situation, maintaining a positive attitude toward the client’s capabilities and potential for improvement. Helping the client to feel accepting about herself and her individual capabilities will promote growth and strengthening of her self-care skills.
5. Promote client and partner’s participation in the planning and evaluating process.
Discharge planning should include helping parents make arrangements for obtaining help from relatives and friends and spacing activities throughout the day to reduce fatigue. The management of one is not effective for the other, therefore, a correct evaluation is necessary so that the woman receives appropriate interventions (Miovech et al., 2013).
6. Develop a plan for self-monitoring with the client.
Share data pertinent to the client’s condition such as laboratory results or blood pressure readings. This provides a sense of control and enables the client to follow their own progress and make informed choices.
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans related to the care of the pregnant mother and her infant:
- Abruptio Placenta | 3 Care Plan
- Cesarean Birth | 10 Care Plans UPDATED!
- Cleft Palate and Cleft Lip | 6 Care Plans
- Dysfunctional Labor (Dystocia) | 4 Care Plans
- Elective Termination | 6 Care Plans
- Gestational Diabetes Mellitus | 8 Care Plans UPDATED!
- Hyperbilirubinemia | 4 Care Plans
- Labor Stages, Induced and Augmented Labor | 36 Care Plans UPDATED!
- Neonatal Sepsis | 5 Care Plans
- Perinatal Loss | 5 Care Plans
- Placenta Previa | 3 Care Plans
- Postpartum Hemorrhage | 8 Care Plans UPDATED!
- Postpartum Thrombophlebitis | 5 Care Plans UPDATED!
- Prenatal Hemorrhage | 9 Care Plans UPDATED!
- Prenatal Substance Dependence/Abuse | 6 Care Plans
- Precipitous Labor | 3 Care Plans
- Preeclampsia and Gestational Hypertension | 6 Care Plans UPDATED!
- Premature Dilation of the Cervix | 3 Care Plans
- Prenatal Infection | 3 Care Plans
- Preterm Labor | 7 Care Plans UPDATED!
- Puerperal Infection | 4 Care Plans
- Cultural Birthing Practices and Experiences. An eBook that details the different cultural and ethnic practices during childbirth in Australia. A great resource if you want to expand your knowledge about these practices.
- Intrapartum Care for a Positive Childbirth Experience. A resource by the WHO that details what they recommend and what they don’t during intrapartum care. Check out the executive summary!
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With contributions by Marianne Belleza RN.