Ch 17 Maximizing Comfort for the Laboring Woman (Exam 2, study guide) Flashcards
abolition of pain perception by interrupting nerve impulses to the brain.
- loss of sensation (partial or complete) and sometimes loss of consciousness occurs
anesthesia
method used to repair a tear or hole in the dura mater around the spinal cord as a result of spinal anesthesia.
- the goal is to prevent or treat postdural puncture headache (PDPH)
autologous epidural blood patch
single-injection, subarachnoid anesthesia useful for pain control during vaginal or cesarean birth (but not for labor)
spinal block (anesthesia)
systemic analgesic, such as nalbuphine, that relieves pain without causing significant maternal or neonatal respiratory depression (is also less likely to cause N/V)
opioid agonist-antagonist analgesic
provides rapid perineal anesthesia for performing and repairing an episiotomy or lacerations
local perineal infiltration anesthesia
anesthetic gas mixed with oxygen, which is inhaled as soon as a contraction begins and meant to reduce, but not eliminate, pain during the first and second stages of labor
nitrous oxide
injection of an opioid agonist analgesic into the spinal fluid to relieve pain associated with labor and following cesarean birth
intrathecal analgesia
class of drug used to decrease anxiety, increase sedation, and reduce N/V, but may impair the analgesic efficacy of opioids
phenothiazine
drug that promptly reverses the effects of opioids, including maternal and neonatal CNS depression, especially respiratory depression
opioid antagonist (narcan)
systemic analgesic such as meperidine or fentanyl that relieves pain and create a feeling of well-being but can result in respiratory depression, N/V
opioid agonist analgesic
alleviation of pain sensation or raising of the threshold for pain perception without loss of consciousness
analgesia
relief from pain of UC and birth by injecting a local anesthetic agent and/or an opioid agonist analgesic into the peridural space
epidural block (analgesia/anesthesia)
relief from pain in the lower vagina, vulva, and perineum, making it useful if an episiotomy is to be performed or forceps/vacuum assistance is required to facilitate birth
pudendal nerve block
type of pain that predominates during the first stage of labor and is located over the lower abdomen
- it results from cervical changes, distention of the lower uterine segment, uterine ischemia, and pressure and traction on adjacent structures
visceral pain (pain related to the internal organs in the midline of the body)
type of intense, sharp, burning pain that predominates during the second stage of labor
Results from:
- stretching and distention of perineal tissues and the pelvic floor to allow passage of the fetus
- distention and traction on the peritoneal and uterocervical supports during contractions
- lacerations of soft tissues
- pressure against bladder and rectum
somatic pain (pain that occurs in the tissues, such as muscles, skin, or joints)
type of pain felt in areas of the body other that the area of pain origin
- during labor and birth, pain originating in the uterus radiates to the abdominal wall, lumbosacral area of the back, iliac crests, gluteal area, and down the thighs
referred pain
point beyond which pain is perceived
pain threshold
level of pain a laboring woman is willing to endure
pain threshold
theory of pain based on the principle that certain nerve cell groupings within the spinal cord, brainstem, and cerebral cortex have the ability to modulate the pain impulses through a blocking mechanism
- according to this theory, pain sensations travel along sensory nerve pathways to the brain, but only a limited number of sensations or messages can travel through these nerve pathways at one time
Gate control
endogenous opioids secreted by the pituitary gland that act on the CNS and PNS to reduce pain
Beta-endorphines
paced breathing technique during which the woman breathes at approx. half her normal rate (6-8 breaths/min)
slow-paced breathing
paced breathing technique during which the woman breathes at an accelerated rate, which should not exceed 2x her resting RR (32-40)
modified-paced breathing
full breath taken at the beginning of each contraction to greet it, and at the end of each contraction blow it away
cleansing breath
paced breathing technique that combines breaths and puffs in a ratio (e.g., 3:1 or 4:1) as a means to enhance concentration during the transition phase of the first stage of labor
pattern-paced (pant-blow) breathing
