Nursing Care Plan for Post Cesarean Section
Mobilization is a person's ability to move freely, easy, organized, have the aim of meeting the needs of a healthy life, and it is important for independence (Barbara Kozier, 1995). Instead, the state of immobilization is a restriction of movement or physical limitations of the limbs and the body itself in spinning, sitting and walking, this one caused by being in a fixed position with reduced gravity as when sitting or lying down. (Susan J. Garrison, 2004).
Cesarean Section is surgery to give birth to the fetus by opening the abdominal wall and the wall of the uterus. (Sarwono, 2005)
Mobilization Post Cesarean Section is a movement, position or any activities conducted mother after a few hours of giving birth by caesarean delivery. To prevent postoperative complications of cesarean section, should be carried out mobilization, according to the stages. Therefore, after a cesarean section, the mother should be rapid mobilization. The faster moving it the better, but mobilization must still be done carefully.
Early mobilization can be performed on the patient's condition improved. In patients with postoperative cesarean section, the first 6 hours is recommended to immediately move the limbs. Gestures that can be done is to move the arms, hands, feet and toes in order to work the digestive organs back to normal soon.
The purpose of mobilization among others:
Mobilization goal is to meet the basic needs (including activities of daily living and recreational activities), defensive (to protect themselves from the trauma), maintaining the concept of self, expressing emotions with non-verbal hand movements.
Benefits Mobilization - Post Cesarean Section
1. Patients feel healthier and stronger with early ambulation.
Losses if not done Mobilization
1. Increased body temperature
Due to the presence of uterine involution is not good that the rest of the blood can not be removed and cause infection and one of the signs of infection are increased body temperature.
2. Abnormal Bleeding
With early mobilization of uterine contractions would be good so fundus hard, then the risk of abnormal bleeding can be avoided, because of the contraction form narrowing of blood vessels open.
3. Uterine involution is not good
Not done early mobilization will inhibit bleeding and retained placenta, causing disruption of uterine contractions.
Range of Motion in Mobilization
According Carpenito (2000) in the mobilization, there are three ranges of motion, namely:
1. Passive Range Of Motion
Passive range of motion is useful to maintain the flexibility of muscles and joints to move the muscles passively others eg nurses lift and move the patient's legs.
2. Active Range Of Motion
It is to train flexibility and muscle strength and joint by using his muscles are active, such as moving the patient lying leg.
3. Functional Range of Motion
Useful to strengthen the muscles and joints to perform activities necessary.
Mobilization Exercise
Mobilization after surgery is the process of post-surgical activities carried out starting from a light workout on the bed (breathing exercises, exercises effective cough, and move the limbs) until the patient can get out of bed, walked into the bathroom and walked out of the room (Brunner & Suddarth, 1996).
Stages of early mobilization on Post Cesarean Section:
Mobilization is a person's ability to move freely, easy, organized, have the aim of meeting the needs of a healthy life, and it is important for independence (Barbara Kozier, 1995). Instead, the state of immobilization is a restriction of movement or physical limitations of the limbs and the body itself in spinning, sitting and walking, this one caused by being in a fixed position with reduced gravity as when sitting or lying down. (Susan J. Garrison, 2004).
Mobilization Post Cesarean Section is a movement, position or any activities conducted mother after a few hours of giving birth by caesarean delivery. To prevent postoperative complications of cesarean section, should be carried out mobilization, according to the stages. Therefore, after a cesarean section, the mother should be rapid mobilization. The faster moving it the better, but mobilization must still be done carefully.
Early mobilization can be performed on the patient's condition improved. In patients with postoperative cesarean section, the first 6 hours is recommended to immediately move the limbs. Gestures that can be done is to move the arms, hands, feet and toes in order to work the digestive organs back to normal soon.
The purpose of mobilization among others:
- Maintain body functions.
- Accelerate blood circulation.
- Assist breathing becomes better.
- Maintain muscle tone.
- Streamlining the elimination of bowel and urine.
- Restoring a specific activity, so that the patient can return to normal and or can meet the needs of daily movement.
- Provide opportunities nurses and patients interact or communicate.
Mobilization goal is to meet the basic needs (including activities of daily living and recreational activities), defensive (to protect themselves from the trauma), maintaining the concept of self, expressing emotions with non-verbal hand movements.
Benefits Mobilization - Post Cesarean Section
1. Patients feel healthier and stronger with early ambulation.
- By moving, the muscles of the abdomen and pelvis will be back to normal so that the stomach muscles become strong again and can thus reduce the pain the mother feels healthy and helps gain strength, speed up healing.
- Bowel and bladder function better.
- With the move will stimulate intestinal peristaltic back to normal.
- This activity also helps speed up the body's organs to work as before.
- Changes that occur in the postoperative mother would quickly recover example uterine contractions, thus the mother will quickly feel healthy and can care for the child quickly.
- With the mobilization of normal blood circulation / smooth so that the risk of thrombosis and thromboembolism can be avoided.
Losses if not done Mobilization
1. Increased body temperature
Due to the presence of uterine involution is not good that the rest of the blood can not be removed and cause infection and one of the signs of infection are increased body temperature.
2. Abnormal Bleeding
With early mobilization of uterine contractions would be good so fundus hard, then the risk of abnormal bleeding can be avoided, because of the contraction form narrowing of blood vessels open.
3. Uterine involution is not good
Not done early mobilization will inhibit bleeding and retained placenta, causing disruption of uterine contractions.
Range of Motion in Mobilization
According Carpenito (2000) in the mobilization, there are three ranges of motion, namely:
1. Passive Range Of Motion
Passive range of motion is useful to maintain the flexibility of muscles and joints to move the muscles passively others eg nurses lift and move the patient's legs.
2. Active Range Of Motion
It is to train flexibility and muscle strength and joint by using his muscles are active, such as moving the patient lying leg.
3. Functional Range of Motion
Useful to strengthen the muscles and joints to perform activities necessary.
Mobilization Exercise
Mobilization after surgery is the process of post-surgical activities carried out starting from a light workout on the bed (breathing exercises, exercises effective cough, and move the limbs) until the patient can get out of bed, walked into the bathroom and walked out of the room (Brunner & Suddarth, 1996).
Stages of early mobilization on Post Cesarean Section:
- In the first 6 hours post SC : Bed rest, early mobilization can do is move the arm, hand, move the toe and ankle twisting, lifting the heel, calf muscles tense as well as bending and sliding the foot.
- In 6-10 hours : Required to be tilted left and right to prevent thrombosis and embolism trombo.
- After 24 hours the mother is encouraged to be able to start learning to sit.
- After the mother can sit, recommended mother learned to walk.
