Question Details

(solution) Synopsis: OPERATIVE CASE STUDY Preoperative Diagnosis: (1)


Synopsis: 

OPERATIVE CASE STUDY

Preoperative Diagnosis: (1) Pregnancy, uterine, nondelivered at 40+3 weeks estimated gestational age, (2) arrest of dilation

Surgeon: Randy Chornack, M.D.

Anesthetist: Dr. Androsini

Anesthesia: Continuous lumbar epidural

Operation Performed: Lower primary cesarean section with Pfannenstiel skin incision and low transverse cervical uterine incision.

Indications For Surgery: The patient is a 29-year-old female, G1 P0 (this abbreviation means the first pregnancy, and that the patient has never delivered a child), last menstrual period May 24, who presented at 40+3 weeks estimated gestational age in early active labor. The patient had progressed through the transition phase at which time an intrauterine pressure catheter was placed due to difficulty assessing contractions on the external monitor. She progressed to 6 cm with fetal vertex at 0 station and in the occiput anterior position. She was contracting every 2 to 3 minutes with contractions that were 64, representative of adequate labor. The fetus had an episode of bradycardia to the 80s lasting approximately 10?12, minutes which responded to resuscitative measures including positioning and application of oxygen with a return to a baseline of 160s with some hypervariability; however, no further deceleration (slowing of fetal heart rate). In the face of adequate spontaneous labor and failure to progress beyond 6 cm for a period of 2 hours and 30 minutes, a decision was made to proceed to primary cesarean delivery.

Findings: At 10:03 p.m., the patient was delivered of a liveborn female infant with Apgar scores of 9 and 9 and weight of 3,422 g.

Description of Operation: In the OR under continuous lumbar epidural, the patient was prepped and draped in the usual fashion for cesarean delivery including sterile insertion of Foley catheter. She was placed in the supine position with a right hip role. A Pfannenstiel skin incision was made, the rectus fascia was dissected off of the underlying muscles that were then separated in the midline, and the peritoneal cavity was entered. The visceroperitoneum overlying the lower uterine segment was elevated, incised, and the bladder was dissected away from the lower uterine segment. A low transverse cervical incision was made and was extended with the bandage scissors. The amniotic cavity was entered, revealing moderate meconium.

The fetal vertex was palpated, elevated, and delivered. The baby was suctioned on the maternal abdomen. The remainder of the infant was delivered. The cord was doubly clamped and cut. The infant was passed up to the pediatricians in attendance. The placenta was manually extracted intact. It was a three-vessel cord. Pitocin and 2 gm of Ancef were added to the IV fluid after delivery of the placenta.

The uterus was exteriorized and the uterine incision was examined. There was found to be a right inferolateral extension. There was also noted to be dissection in the myometrial layers of the lower uterine segment where a venous sinus had been entered with copious bleeding. This was controlled with interrupted figure-of-eight sutures and reapproximation of the myometrial layers. Closure of the right inferolateral extension incorporated the right uterine artery in the repair. This was closed in a running locking fashion with #1 chromic suture, as was the remainder of the uterine incision. Good hemostasis was obtained. The bladder flap was then approximated using a running stitch of 2-0 chromic suture. The abdominal cavity was thoroughly irrigated and suctioned free of clots. The uterus was returned to the abdominal cavity, the parietal peritoneum and the fascia were closed. The subcutaneous tissues were thoroughly irrigated and found to be hemostatic. The skin was closed with staples and sterile dressing was applied. The patient left for the recovery room in stable condition. She received 2400 cc of lactated Ringer's interoperatively and had 125 cc of urine output. Estimated blood loss was 1,000 cc.

The patient tolerated the procedure well. There were no complications.

Addendum: The pediatricians suctioned the infant postpartum, revealing no meconium below the cord.


Question or Statement:  Given the above Operative Case Study, identify one or two situations in which appropriately and accurately used medical terminology enables health information professionals to successfully support clinical staff functions


 


Solution details:
STATUS
Answered
QUALITY
Approved
ANSWER RATING

This question was answered on: Jan 30, 2021

PRICE: $15

Solution~0001000629.zip (25.37 KB)

Buy this answer for only: $15

This attachment is locked

We have a ready expert answer for this paper which you can use for in-depth understanding, research editing or paraphrasing. You can buy it or order for a fresh, original and plagiarism-free solution (Deadline assured. Flexible pricing. TurnItIn Report provided)

Pay using PayPal (No PayPal account Required) or your credit card . All your purchases are securely protected by .
SiteLock

About this Question

STATUS

Answered

QUALITY

Approved

DATE ANSWERED

Jan 30, 2021

EXPERT

Tutor

ANSWER RATING

GET INSTANT HELP/h4>

We have top-notch tutors who can do your essay/homework for you at a reasonable cost and then you can simply use that essay as a template to build your own arguments.

You can also use these solutions:

  • As a reference for in-depth understanding of the subject.
  • As a source of ideas / reasoning for your own research (if properly referenced)
  • For editing and paraphrasing (check your institution's definition of plagiarism and recommended paraphrase).
This we believe is a better way of understanding a problem and makes use of the efficiency of time of the student.

NEW ASSIGNMENT HELP?

Order New Solution. Quick Turnaround

Click on the button below in order to Order for a New, Original and High-Quality Essay Solutions. New orders are original solutions and precise to your writing instruction requirements. Place a New Order using the button below.

WE GUARANTEE, THAT YOUR PAPER WILL BE WRITTEN FROM SCRATCH AND WITHIN A DEADLINE.

Order Now