1, postpartum care
Related gynecologists have given detailed answers to the questions about postpartum care of caesarean section, as follows. Let's have a look.
(1) On the day of caesarean section, the parturient must have a good rest, which is also a major operation. At this time, the parturient will have the stimulation of catheter, the cuff winding of ECG monitoring and the discomfort of oxygen inhalation tube, and some patients have analgesic pumps on their backs. After the baby is born, it will attract your mother a lot. Mothers will always pay attention to their children. In addition to reminding her to feed her children, she should also pay attention to rest, so that her physical strength can recover faster.
(2) After the catheter is removed, the parturient should do more activities as soon as possible. You can sit up first, then move around the bed, and then move underground. Don't lie still in bed, which will affect the blood circulation of lower limbs and lead to deep phlebitis of lower limbs. At the same time, we should also pay attention to maternal hygiene, change clothes frequently, and try to wear some clothes that absorb sweat and are loose.
2, wound care
(a) closely observe the local situation of the wound after cesarean section.
After cesarean section, special attention should be paid to the healing and nursing of abdominal wounds. Cesarean section wounds are divided into two types, straight mouth and transverse incision. No matter what kind of incision, the surgeon should pay special attention to the alignment of the wound during suture, and the sandbag should be placed on the wound for 6 hours after operation. The recovery contract of cesarean section needs 1 week, because the wound is large and the probability of infection is high. In addition, obese new mothers are prone to wound infection because of their thick subcutaneous fat. On the second day after delivery, change the wound dressing and check for bleeding and redness. Under normal circumstances, the wound should be changed twice after operation, and the stitches should be removed on the seventh day. If the patient is obese, or has diabetes, anemia and other diseases that affect wound healing, it is necessary to delay the removal of stitches. If the new mother has a high temperature and the wound is painful after operation, she should check the wound in time. If swelling is found, she can use 95% alcohol gauze to wet compress it twice a day. If it doesn't improve after application, the wound is swollen and has a sense of fluctuation, and it is confirmed that there is infection, even if the stitches are removed, it should be drained. Change the dressing of the wound every day and observe whether the wound is clean and fresh. If the wound is changed every day, the drainage gauze has no secretion and the wound is fresh, consider secondary suture. The suture should not be stretched too tightly. Observe whether there is exudation from the wound. If there is more exudation and the wound is not fresh, secondary suture is not considered. Try to drain thoroughly, otherwise it will not be easy to heal.
Because of the large range of postoperative wounds, stitches or wallets can be removed 5-7 days after operation. But full recovery takes 4-6 weeks. The new mother who just gave birth to a child has weak body resistance, and a little carelessness may cause wound infection. Therefore, we must take good care of the wound to avoid adding more trouble to the already busy month.
(2) Assist the new mother to turn over after operation.
Anesthetic drugs can inhibit intestinal peristalsis and cause flatulence and abdominal distension in different degrees. After the postoperative consciousness is restored, physical activities should be carried out. /kloc-after 0/2 hours, give the new mother some senna water to help relieve abdominal distension. At the age of 24, I helped my new mother practice turning over, sitting up and getting out of bed slowly, which can enhance gastrointestinal peristalsis, expel morning gas, and prevent intestinal adhesion and thrombosis from causing embolism in other parts. You can also massage Zusanli, Hegu, Neiguan and other acupoints to promote the recovery of gastrointestinal function.
(3) Encourage new mothers to urinate by themselves.
In order to facilitate the operation, catheter is usually placed before cesarean section. 24-48 hours after operation, the influence of narcotic drugs disappears, and bladder muscle can restore urination function. At this time, the catheter can be unplugged, and the new mother is required to urinate on her own as long as she has a sense of urination, so as to reduce the indwelling time of the catheter and avoid bacterial infection in the urinary tract. If the new mother has difficulty urinating for the first time, she can listen to the sound of running water or clean the perineum with warm water in the kettle to induce urination.
(d) Help new mothers find suitable places.
After cesarean section, the body recovers slowly, unlike the new mother who gives birth naturally in the female private parts, and can get up and move 24 hours after delivery. Because, the new mother of cesarean section is prone to the problem that lochia is not easy to discharge. If you take a semi-recumbent position and turn over more, you can promote the discharge of lochia, avoid infection caused by intrauterine deposition, affect uterine reset, and be conducive to incision healing. After the operation, the anesthetic effect disappeared, and the new mother felt pain in the wound, especially the pain of uterine contraction in supine position. At this time, the new mother should be assisted to take the lateral position, so that the body and the bed form an angle of 20-30 degrees, and a quilt or blanket should be put on the back to reduce the vibration and pulling pain of the incision during physical activities.
(5) Keep the abdominal incision clean.
Avoid wetting the abdominal incision within 2 weeks after operation and take a bath to clean your body. You can take a shower afterwards, but you are not allowed to take a shower until the lochia is completely discharged. Wash vulva 1-2 times a day, and don't let dirty water enter female private parts. If the wound is red, swollen, hot and painful, don't squeeze and smear it at will to remind the new mother to seek medical treatment in time.
(6) Encourage new mothers to use painkillers as little as possible.
After cesarean section, anesthesia gradually disappeared, abdominal wound pain began to recover, and generally severe pain began several hours after operation. In order to have a good rest and let the body recover as soon as possible, some analgesic drugs can be used appropriately. But after that, we should encourage new mothers to be as patient as possible so as not to affect the recovery of gastrointestinal function. Generally speaking, the pain of the wound will disappear by itself after 3 days.
(7) Encourage new mothers to get up as soon as possible.
As long as physical strength permits, get out of bed as soon as possible after delivery and gradually increase the amount of activity. This can not only promote intestinal peristalsis and uterine contraction, but also avoid intestinal adhesion. thrombophlebitis
(8) Eating should not be too full.
During cesarean section, the intestine is not only stimulated, but also the normal function of gastrointestinal tract is inhibited, and the intestinal peristalsis is relatively slow. Eating too much will increase intestinal metabolites and prolong the retention time in the intestine, which will not only cause constipation, but also increase gas production and abdominal pressure, which is not conducive to rehabilitation. Therefore, we should fast within 6 hours after operation, and then gradually increase our food intake.
(9) Even defecation
After cesarean section, because of pain, the abdomen does not dare to exert force, and urine can not be discharged in time, which is easy to cause urinary retention and constipation. Therefore, the new mother should urinate in time according to her usual habits after operation.
(10) prevent colds.
Cold and cough can affect wound healing, and severe cough can even cause incision tearing. Therefore, it is necessary to explain to the new mother to guard against catching a cold. A new mother with a cold should take medicine in time. In addition, it is necessary to ensure the cleanliness of abdominal incision and female private parts. Don't scratch the edge when it itches, and don't scrub it with unclean things.
(eleven) to guide the new mother to do fitness exercises.
After cesarean section 10 days or so, you can do physical exercise when you recover well. The method is as follows.
1. Lie on your back, lift your legs alternately, first perpendicular to your body, then slowly put them down, and do it five times respectively.
2. Lie on your back, naturally put your arms on your sides, bend and lift your right leg, and make your thighs as close as possible to your abdomen, your heels as close as possible to your hips, and alternate your left and right legs five times each.
3. Lie on your back, knees bent, arms crossed on your chest, then slowly sit down in a semi-sitting position, and then resume your supine position.
4. Lie on your back, bend your knees, straighten your arms and do sit-ups.
5. Prone position, legs bent to the chest, thighs perpendicular to the bed, hips raised, chest close to the bed, do 1 time in the morning and evening, and gradually extend from 2-3 minutes to 10 minutes each time.
3, nursing points
(1) the day after caesarean section
On the day of cesarean section, the parturient must have a good rest after returning to the ward, because this is a major surgical experience after all. At this time, there will be stimulation of catheter, discomfort of oxygen inhalation tube, cuff entanglement of ECG monitoring, and analgesia pump on the back.
After the birth of the child, it gave the mother great attraction. Mothers will continue to pay attention to their children and remind them to close their eyes and rest at other times except when they need to breastfeed their children, so as to recover their physical strength as soon as possible. Turn over more after delivery, promote exhaust as soon as possible, eat as soon as possible, and supplement the physical loss caused by surgery.
(2) The day after caesarean section
After removing the catheter on the second day after delivery, you should exercise as soon as possible. You can sit up first, then exercise beside the bed, and then exercise on the ground. Never lie still in bed, which will affect the blood circulation of lower limbs and cause deep phlebitis of lower limbs. There will be pain in the wound when the analgesic pump is pulled out, and there will be contraction pain when the child sucks the breast. These pains are very painful for cesarean section women who have never experienced labor, so they must bite their teeth and get over it. The pain of uterine contraction when a child is breastfeeding is as tolerable as slight dysmenorrhea during menstruation. Only in this way can the uterus contract from a spherical organ as big as a ball to the size before pregnancy.
Puerperal sweating will occur, which means that the water stored in the body during pregnancy is excreted in the form of puerperal sweating. Don't think that you are sweating because you are weak. Change clothes every day and keep your body clean. The nurse will help the parturient clean the vulva and keep it clean. Transfusion is needed two days before delivery to supplement the energy shortage caused by intraoperative loss and inability to eat as soon as possible after operation; Doctors also give antibiotics to pregnant women to prevent infection.
(3) The 3rd day after caesarean section.
On the third day, my mother basically adapted to the pain of contractions. At this time, the doctor will change the dressing for the wound, and there may be slight discomfort. The doctor will check whether the wound has oozing blood, redness and inflammation to understand the wound healing. The most important thing is to start increasing milk at this time (usually 24 ~ 48 hours after delivery). Need maternal bullet through this stage, you can dredge the mammary duct through breast massage to ensure that children have enough breast milk to eat.
Generally, you can wash your hair, brush your body and dry your hair with hot air in a warm room on the third day after delivery. You can take a bath in a warm bathroom for a week, but you should pay attention to protecting the wound. Brush your teeth every day after delivery to protect your teeth.
4. Nursing contraindications
(1) One of the dangerous actions after caesarean section: supine.
Because after caesarean section, with the gradual fading of anesthesia effect, the pain of incision will appear, and the pain of uterine contraction in supine position is the most sensitive, so we should take the lateral position, make the body form an angle of 20-30 degrees with the bed, and put a quilt or blanket on the back to reduce the auditory impact and pulling pain on the incision during physical activities.
(2) The second dangerous action after caesarean section: inactivity.
After your consciousness is restored after the operation, you should do sports. Practice turning over and sitting up after 24 hours, and get out of bed slowly, because only moving the intestines can move, and moving the intestines can exhaust. You can eat slowly when you exhaust, and you can eat something that sucks milk after you resume your diet, so that the milk can be further secreted. This will help the puerpera recover, promote urination and defecation, promote lochia discharge, and prevent intestinal adhesion and thrombosis from causing embolism in other parts.
(3) The third dangerous action after caesarean section: Do not dare to urinate.
After caesarean section, due to pain, the parturient does not dare to exert force on the abdomen, which is easy to cause urinary retention and constipation. Therefore, postpartum women should urinate in time according to their usual habits, drink plenty of water at ordinary times, flush the urethra to prevent infection, but don't drink too much, and urinate when the bladder feels.
(4) The fourth dangerous action after caesarean section: sitz bath or basin bath.
After caesarean section, the parturient can't take a bath before the wound is taken out. In order to keep the abdominal wound dry and clean, she can scrub the area with warm water, or ask a doctor to waterproof the abdominal wound before taking a bath.
It should be noted that the cervix is not closed within four weeks after delivery, so do not take a bath or a basin bath to avoid uterine or pelvic infection. But the vulva should be washed 2~3 times a day. Women with side incisions should clean their vulva after defecation.
(5) The fifth dangerous action after caesarean section: big fish and big meat.
After caesarean section, the parturient will consume a lot of energy and need to supplement nutrition in time, but it is not advisable to eat a lot of high-protein food immediately. After one week, the parturient should abstain from eating eggs, fermented food and milk to avoid flatulence. A week later, the parturient can start eating fish, fresh milk, chicken essence and meat with high protein to help tissue repair. At the same time, we should eat less greasy, dark pigments and irritating foods, such as coffee, tea, peppers, wine, etc., and eat more nutritious, high-calorie and digestible foods.
(6) The sixth dangerous action after caesarean section: sexual life.
If lochia is unclean or within 42 days after delivery, sex is absolutely forbidden, because the uterine wound has not been completely repaired. If you forget martial law for a temporary pleasure, it is easy to cause puerperal infection and even chronic pelvic inflammatory disease. Women who have lochia earlier must take reliable contraceptive measures when resuming their sexual life, because puerperal pregnancy is also a common thing and should be paid attention to.
(7) The seventh dangerous action after caesarean section: blowing cold.
The pores of postpartum women will be completely opened, which is a time of "weakness". If the refrigeration setting temperature such as air conditioner is too low, the parturient will catch a cold, which is not only easy to catch a cold, but also easy to fall into the root cause. Therefore, pay attention to the fact that the air conditioner cannot directly blow the parturient, and the room temperature is generally 25-28 C. Maternal women should wear long-sleeved clothes and trousers, preferably a pair of thin socks, not exposed.