Exam 2 - Intrapartum Pain Mgmt Flashcards
A variety of physiologic factors that can affect the intensity of birth pain and fatigue can interfere with ability to cope
pain in labor
the primary source of pain in stage 1 of labor is ____
dilation of the cervix
hypoxia of uterine muscle cells during contractions causes pain in which stages?
stage 1 and 2
what causes pain in stage 3 of labor?
(1) cervical dilation of the placenta is expelled
(2) uterine contractions
(3) perineal pain
when assessing pain, nurses should ask:
“are you coping with your labor?”
name 3 signs that a pt is NOT coping well
(1) states that they aren’t
(2) panicked
(3) tense
(4) crying
(5) fear
pain management should not interfere with ____
the course of labor
name the pain management options from least to most invasive
(1) nothing
(2) nonpharmacological comfort
(3) nitrous oxide
(4) sedatives - vistaril
(5) opioids
(6) pudendal nerve block
(7) epidural analgesia
(8) spinal anesthesia
At what phase is it no longer safe to give an epidural?
stage 2 - pushing phase
name the pain management options that are safe during early labor phase
(1) non-pharm methods
(2) NO
(3) sedatives
(4) opioids
(5) epidural
name the pain management options that are safe during active labor phase
(1) non-pharm methods
(2) NO
(3) opioids
(4) epidural
name the pain management options that are safe during stage 2
(1) non-pharm methods
(2) NO
(3) local infiltration
name the pain management options for stage 3
(1) non-pharm methods
(2) NO
(3) opioids
(4) local infiltration
Name at least 3 non-pharm comfort measures
(1) heat/cold
(2) touch/massage
(3) psychosocial comfort
(4) hydrotherapy
(5) counterpressure
(6) knee press
(7) birth ball
____ does not stay in the system after they stop inhaling the substance
Nitrous oxide
sedatives such as ____ are used for ____
Vistaril; relaxation and sometimes sleep
which opioid is most commonly used in early labor phase?
Morphine IM
which opioid is more rapid-acting?
Fentanyl
What happens if opioids are given too late in labor?
no relief and can cause neonatal respiratory depression
what needs to be present when using opioids?
Narcan
some pain relief and motor block
regional analgesia
complete pain relief and motor block
regional anesthesia
what is the primary use of local perineal infiltration anesthesia?
repair of perineal lacerations
Use of needle guide and luer-lok syringe to inject medication
pudendal nerve block
when can pudendal nerve block be used?
2nd and 3rd stages of labor
spinal anesthesia is used during ___
c-section
name the 2 advantages of spinal anesthesia for pregnant person
(1) awake and can participate in birth
(2) retain airway reflex
name at least 3 limitations of spinal anesthesia
(1) maternal hypotension
(2) FHR changes
(3) delayed respiratory depression
(4) N/V
(5) pruritus
(6) urinary retention
(7) spinal headache
____ leads to reduced motor function from xiphoid process down to toes
spinal block
Pts can typically have movement in legs - can’t walk, but there is still some ability with ____
epidural block
Continuous infusion via catheter of anesthetic (Marcain) and opiate (Fentanyl) injected into the epidural space between L4 and L5
Epidural
general anesthesia is reserved for ___
emergency situations i.e., STAT c-section
name the postpartum pain management for NSVB
(1) analgesic PO (acetaminophen)
(2) NSAID PO (ibuprofen)
(3) topical comforts
name the postpartum pain management for c-section delivery
(1) opioid analgesic PCA x24 hr; then PO
(2) NSAID IV x24 hrs; then PO
IV and PO _____ cannot be used at the same time
NSAIDs
