A 29-year-old woman is in the emergency department (ED)with a ruptured appendix.Before the ED room nurse and surgical resident transported her to the OR,the nurse called to inform them that the patient is 27 weeks' pregnant.What special considerations must the perioperative nurse and anesthesia provider address with this new information?

Question

Quizplus · Accepted Answer

Special considerations for the obstetric surgical patient include continuous monitoring of the fetal heart rate,administration of a regional anesthetic before placing the patient in the supine position,rapid induction for general anesthesia,and preparation for the possible use of tocolytics (e.g.,medications to decrease uterine activity)to prevent labor.Ready access to neonatal resuscitative drugs and equipment should be established when performing surgery on pregnant women in the second trimester and beyond.If permitted by the surgical approach,the pregnant woman should be positioned with a lateral tilt or with a wedge or pillow under her right hip to provide uterine displacement and relieve pressure on the maternal vena cava.This position promotes blood flow to the placenta.

A 29-Year-Old Woman Is in the Emergency Department (ED)with a Ruptured