chapeter 8 ob management of pain during labor

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  1. what is cognitive stimulation
    using a focal point  or focusing on breathing patterns or a spot on the wall to help woman block out painful sensations. requires her active participation.
  2. sacral pressure
    palm, closed fist or firm object is pressed at point of back pain
  3. cutaneous stimulation
    touching rubbing or massaging back or shoulders for comfort
  4. how to recognize and correct hyperventilation
    -corrective measures
    • S/S: dizziness, tingling of hands and fee, cramps and muscle spasms of hands, numbness around nose and mouth, blurry vision
    • CORRECTIVE MEASURES: -breathe slowly
    •  especially in exhalation,
    • -breathe into cupped hands,
    • -place moist cloth over mouth while breathing,
    • -hold breathe for a while before exhaling
  5. Analgesics used to reduce the perception of pain in labor
    • Merperidine
    • sublimaze, fentanyl
    • butorphanol, stadol & nalbuphine, nubain in combination opiod agonist-antagonist
    • narcain, naloxone
  6. sedatives used during labored
    • phenobarbital does not relieve pain but  relieves anxiety and nausea.
    • - it crosses the placenta and affects the fetus
    • -phenobarbital has no antagonist to assist  new born who may have respiratory depression
    • -usually not given during labor
  7. Adjunctive drugs
    • phenothiazine med: phenegran (promethazine) or vistaril (hydroxyzine_
    • -control nausea and anxiety
    • -do not relieve pain, used with opiods
    • -vistaril cannot be given IV
    • Flumazenil is an antagonist that can reverse maternal drug induced sedation and ventilator depression
  8. REGIONAL ANESTHESIA when is it given and where does it block feeling
    -pudenal block
    -epidural block 
    -spinal  subarachnoid block
    -if IM regional anesthesia is ordered where is it given
    • -pudendal block: given when woman is ready for labor and anesthesizes lower vagina and part of the perineum
    • -epidural block: can be given during first and second stages of labor
    • -spinal subarachnoid block: used for cesarean births ( monitor mothers VS and FHR)
    • -if IM injection is ordered give it the deltoid for better absorption
  9. common SE of epidural and subarachnoid blocks
  10. contradictions to epidural and subarachnoid blocks
    • hypovolemia ( hemorrhage)
    • anticoag therapy or clotting disorder
    • allergy or infection at injection site
  11. general anesthesia risk and what should be reported to MD
    • -if woman reports numbness of chest, tongue or face or has difficulty taking a full breath anesthesia given to high and MD should be notified STAT
    • -regurgitation and aspiration of gatstric contents
  12. Nursing Role for regional anesthesia
    • -make sure bladder is emptied before insertion
    • aasist with positioning
    • monitor for hypotension if it occurs give ringers latate or NS
    • monitor FHR
    • assist position changes
  13. signs of toxicity to local anesthesia (RARE OCCURANCE)
    • disorientation
    • tinnitus
    • twitching
    • seizures
  14. SE from Spinal blocks
    headache-caused by leakage of spinal fluid (bed rest in flat position to relieve headache may occur in postpartum period)
  15. to relive SE of Spinal block
    avoid coughing or staring bowel movement for a few days
Card Set:
chapeter 8 ob management of pain during labor
2015-01-11 06:55:11
maternity ob
materniy,eastern suffolk boces
maternity ob chapter 8 eastern Suffolk boces
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