Chapter 17

Question 1

Pain from the distention of the uterus, stretching of the cervix (Dilation and Effacement), and pressure on adjacent structures during the first stage of labor.

Answer 1

Visceral Pain

Question 2

Pain that originates in the uterus and radiates to the abdomen, thighs, and back.

Answer 2

Referred pain

Question 3

Pain during the second stage of labor, described as intense, sharp, burning, and localized.

Answer 3

Somatic pain

Question 4

Expressions of pain include triggering of the _______ nervous system and ________ catecholamine levels. ______ blood pressure and heart rate, _______ oxygen consumption/ ______ ventilation. ______ gastric acid with nausea and vomiting. _______ placental perfusion and uterine activity.

Answer 4

Sympathetic, increase, increase, increase, hyper, increase, decrease.

Question 5

Theory that pain stimuli can be ignored through a blocking mechanism

Answer 5

.Gate-control theory of pain

Question 6

Breathing technique where the mother takes a breath in through the nose and out through the mouth. When should this technique be used? Why?

Answer 6

Cleansing breath, before and after contractions. To greet contraction and blow it away to ensure oxygenation.

Question 7

Breathing technique where mother breathes at half the normal breathing rate (6-8 breaths per minute): IN-2-3-4, OUT-2-3-4. When is this used? Why?

Answer 7

Slow-paced breathing. Initiated when mother can no longer walk/talk through contractions. Used to promote oxygenation and relaxation

Question 8

Breathing technique performed at twice the normal rate (32-40 breaths per minute) (IN-OUT, IN-OUT). When is this used? Why?

Answer 8

Modified-paced breathing, When contractions increase in intensity and frequency, to concentrate on breathing and block painful stimuli

Question 9

Breathing pattern that uses 3:1 or 4:1 ratio (pant-pant-pant-blow). When is this used? Why?

Answer 9

Patterned-paced/Pant-blow breathing. During transition phase when cervix dilates from 8-10cm, used for concentration.

Question 10

Complications of fast patterned breathing are… Interventions include…

Answer 10

hyperventilation, respiratory alkalosis (lightheadedness, dizziness, tingling)

• Have woman breathe into paper bag or cupped hands.
• Ensure rate is no more than twice normal breathing rate

Question 11

Relieve anxiety and induce sleep and used for women in prolonged latent phase of labor. Examples include…

Answer 11

Sedatives: barbiturates, pheothiazines (phnergan), benzodiazepines

Question 12

Encompasses analgesia, amnesia, relaxation, and reflex activity. Interrupts nerve impulses to the brain and causes loss of sensation and sometimes LOC.

Answer 12

Anesthesia

Question 13

The alleviation of the sensation of pain or the raising of the threshold for pain perception without loss of consciousness

Answer 13

Analgesia

Question 14

What is the importance of naloxone

Answer 14

Reverses opiod induced respiratory depression in mother and may be administered to the newborn if recent opioid administration close to birth

Question 15

Signs and symptoms of Maternal Opioid Abstinence Syndrome

Answer 15

Yawning, goose bumps, anorexia, sneezing, muscle spasms, pupil dilation, sweating, runny nose, and diarrhea
*DO NOT give naloxone

Question 16

True or False: Pudendal nerve block with relieve pain felt from contractions

Answer 16

False

Question 17

Treatment for post-dural puncture headache

Answer 17

Caffeine, analgesics, epidural blood patch

Question 18

Biggest risk associated with general anesthesia

Answer 18

Aspiration

Question 19

Nursing interventions to prevent aspiration during general anesthesia

Answer 19

NPO, IV access, oral antacid (Bicitra/sodium citrate-citric acid), follow possible orders for H2 receptor blockers (INEs) and metoclopramide/reglan (accelerates gastric emptying).