PREOPERATIVE AND POSTOPERATIVE HEALTH CARE AND NURSE PROCEDURES FOR CESAREAN SECTION

Porod označava završetak razdoblja nošenja fetusa koje se spontano ili asistirano dovršava rađanjem jednog ili više plodova. Prema načinu početka porođaja, porod se definira kao spontani ili izazvani (inducirani). Operacijskim porodom dovršava se trudnoća kirurškim putem (carski rez) ili vaginalnim opstetričkim zahvatom. Carski rez (lat. sectio caesarea) je opstetrička operacija kojom se dijete zajedno sa sekundinama, porađa postupkom otvaranja trbušne šupljine (laparatomija) i materišta (histerotomija), a potom se maternica i trbušna stijenka sašiju. Postupak se može primijeniti kod rodilja gdje se nisu aktivirali mehanizmi rađanja i tada je riječ o primarom carskom rezu. Sekundarni carski rez intervencija je na koju se odlučuje nakon što je porođaj započeo. Prema hitnoći postupka, postoji elektivni (unaprijed dogovoren, planiran) i hitni carski rez (neplanirani). Indikacije za obavljanje carskog reza mogu biti apsolutne (kod kojih ni na koji način porod prirodnim, vaginalnim putem nije moguć, ili je život majke i/ili ploda ugrožen), relativne (porod vaginalnim putem je moguć, ali postoji određeni rizik za zdravlje majke i/ili ploda) i proširene indikacije (temeljni cilj je prevencija ili uklanjanje ugroženosti ploda). Komplikacije carskog reza su infekcija operativne rane, puerperijsko krvarenje, febrilnost babinjače, ragade mamile i upala bradavice, oslabljena funkcija mokraćnog mjehura i psihička neprilagođenost. Medicinska sestra treba obaviti temeljitu procjenu zdravstvenog stanja babinjače i pažnju usmjeriti na moguće uzroke komplikacija. Prijeoperacijska zadaća medicinske sestre obuhvaća psihofizičku pripremu koja uključuje pružanje emocionalne podrške, procjenu stanja pacijentice, uvođenje intravenske kanile, primjenu premedikacije, pripremu probavnog i urinarnog sustava, pripremu operacijskog polja i edukaciju. Poslijeoperacijska zadaća uključuje provođenje poslijeoperacijske procjene stanja pacijentice, nadzor nad vitalnim funkcijama, pružanje pomoći prilikom ustajanja, previjanje i nadzor operativne rane te provođenje edukacije o skrbi za dijete, pružanje podrške prilikom dojenja te naglašavanje važnosti odmora i spavanja, pravilnog načina života i konzumiranja raznovrsnih namirnica.Childbirth means the end of the period of carrying a fetus which is completed spontaneously or by medical assistance and ends with the birth of one or more fetuses. According to the mode of onset of labor, labor is defined as spontaneous or induced. Surgical delivery means that pregnancy is completed surgically by cesarean section or by vaginal obstetric intervention. Cesarean section (lat. sectio caesarea) is an obstetric operation by which the child, together with the seconds, is born birth by opening the abdominal cavity (laparotomy) and uterus (hysterotomy), and then the uterus and abdominal wall are sutured. The procedure can be applied to mothers where the mechanisms of childbirth have not been activated and then it is a primary caesarean section. Secondary caesarean section is an intervention that is performed after the birth has started. According to the urgency of the procedure, there is an elective (pre-arranged, planned) and emergency caesarean section (unplanned). Indications for caesarean section can be absolute (in which natural, vaginal birth is not possible in any way, or the life of the mother and/or fetus is endangered), relative (vaginal birth is possible, but there is a certain risk to the mother's health and/or fetus) and extended indications (the basic goal is the prevention or elimination of fetal endangerment). Complications of caesarean section are infection of the operative wound, puerperial bleeding, febrile puerperium, nipple cracks and nipple inflammation, impaired bladder function and psychological maladaptation. The nurse should perform a thorough assessment of the puerperal woman's health and focus on possible causes of complications. The preoperative role of the nurse includes psychophysical preparation which includes providing emotional support, assessing the patient's condition, introducing an intravenous cannula, applying premedication, preparing the digestive and urinary system, preparing the operating field and education. The postoperative role includes a postoperative assessment of the patient's condition, monitoring vital signs, providing assistance in getting up, dressing and monitoring the operative wound and providing education on child care, providing support during breastfeeding and emphasizing the importance of rest and sleep, proper lifestyle and consumption of various food