Pain managment for childbirth chapter 18

Childbith pain is unique because it is normal and self-limiting can be prepared for and ends with a baby's birth

Excess or poorly relieved pain can be harmful to the mother and fetus

Pain is complex physical and psychologic experience.  It is subjective and personal

Four sources of pain cervical dilation uterine ischemia pressure and pullin on pelvic structurs and vaginal and perineal distention are present in most labors.  other physical and psychologic factors may alter the pain felt from these sources

Relaxation enhances other pain management techniques

Any drug that teh expectant mother takes wheter therapeutic herbal/botanical or abused may affect the fetus directly or indirectly

Cutaneous and mental stimulation techniques reduce pain perception.  Techniques shoul be varied to prevent habituation

The purpose of breathing techniques is to increase relaxation

physiologic alterations of pregnancy may affect a womens response to medications

Major advantages of regional pain management  methods are tehat the woman can participte in the birth and that she retains her protective airway reflexes

The nurse should observe for and take actions to prevent maternal hypotension with an eqidural or SAB

THe main nursing obsrevations for the woman who receives eqidural or intrathecal opioids are for nausea and vomiting pruritus and delayed resp depression

THe nurse should observe for respiratory depression primarily in the newborn when the mother has received opioid analgesics during labor

Regurgitation with aspiration of acidic gastric contents is the greatest risk for a woman who receives general anesthesia

Blocking effect of a drug

loss of sensation with or without loss of consciousness

Maximum pain one is willing to endure

Relief of pain without loss of consciousness

Causing a physiologic effect

natural substance similar to morphine

Explain how childbirth pain differs from other pain?

how can excessive pain reduce fetal oxygenation

How is labor accected when teh fetus is in occiput posterior (OP) position

List four categories of non-pharmacologic techniques that can be used during labor

Give an example of both direct and indirect effects of maternal drugs on the fetus

What is the purpose of giving a test dose before doing an epidural block? What would be signs of problems after the test dose and what causes these signs

What causes the adverse reactions to epidural block analgesia/anesthesia? What may be done to prevent or correct: HEADACHE

What causes the adverse reactions to epidural block analgesia/anesthesia? What may be done to prevent or correct: HYPOTENSION

What causes the adverse reactions to epidural block analgesia/anesthesia? What may be done to prevent or correct: BLADDER DISTENSION

What causes the adverse reactions to epidural block analgesia/anesthesia? What may be done to prevent or correct: PROLONGED 2ND STAGE LABOR

In which regional anesthesia method is it desirable to obtain cerebrospinal fluid (CSF)? Why?

List methods to relieve pain of a postspinal headache.

Under what two circustances should butorphanol (stadol) or nalbuphine (Nubain) not be given to a woman in labor?

Firm sacral pressure is likely to be most helpful in which situation?

A woman receives meperidine (demerol) during labor.  Because this analgesic is being used the nurse should have on hand?

When stocking a cart for epidural analgesia teh most important nursing action is to?

The appropriate nursing action for a woman who has a postspinal headache is to?

A woman having her first baby is trying to use breathing techniques during labor but she has difficulty concentrating.  She is 3cm dilated 80% effaced and the station is 0.  WHat nursing measure can best help her?

A woman must have general anesthesia for planned cesarean birth because of previous back surgery.  THe nurse should therefore expect to administer:

A nurse is caring for a client who is at 40 weeks of gestation and experiencing contractions that are every 3-5 min which are becoming stronger. Vaginal exam reveals that teh client cervix is 3 cm dilated 80 % effaced and -1 station.  The client states taht she wants pain medication at this time which of the following interventions should the nurse suggest to the client at this time? (all that apply)

A nurse is caring for a client who is in active labor.  the client reports lower back pain.  The nurse suspects that this pain is persistent occiput posterior presentation.  WHich of the following nonpharmacological nursing interventions should best alleviate this pain.

A nurse anesthetist is explaining an eqidural procedure to a client who agrees that this is the best way to help suppress her pain. What is the role of the nurse before during and after administration of and epidural (all that apply)

A nurse is caring for a client who is primipara and in active labor.  The client received meperidine  (demerol) 50 mg IV for pain 30 min prior to precipitous delivery.  Which of the following medications should the nurse be prepared to administer.

A nurse is caring for a client who is in labor.  Which of the following should the nurse assess for following placement of an epidural?

a client in laborand delivery unit is in the second stage of labor. Her labor has been progressing well without complications ans she is expected to deliver vaginally in 20 min.  The primary care provider is preparing to administer lidocaine (xylocaine) for pain relief and preform an episiotomy.  The nurse knows that this type of regional anesthetic block that will likely be used with which of the following?

A  nurse caring for a client in labor.  The client experienes hypotension and fetal bradycardia.  Which of the following nursing actions should the nurse implement (all that apply)