Exam 2 - Intrapartum Pain Mgmt

Question 1

A variety of physiologic factors that can affect the intensity of birth pain and fatigue can interfere with ability to cope

Answer 1

pain in labor

Question 2

the primary source of pain in stage 1 of labor is ____

Answer 2

dilation of the cervix

Question 3

hypoxia of uterine muscle cells during contractions causes pain in which stages?

Answer 3

stage 1 and 2

Question 4

what causes pain in stage 3 of labor?

Answer 4

(1) cervical dilation of the placenta is expelled
(2) uterine contractions
(3) perineal pain

Question 5

when assessing pain, nurses should ask:

Answer 5

“are you coping with your labor?”

Question 6

name 3 signs that a pt is NOT coping well

Answer 6

(1) states that they aren’t
(2) panicked
(3) tense
(4) crying
(5) fear

Question 7

pain management should not interfere with ____

Answer 7

the course of labor

Question 8

name the pain management options from least to most invasive

Answer 8

(1) nothing
(2) nonpharmacological comfort
(3) nitrous oxide
(4) sedatives - vistaril
(5) opioids
(6) pudendal nerve block
(7) epidural analgesia
(8) spinal anesthesia

Question 9

At what phase is it no longer safe to give an epidural?

Answer 9

stage 2 - pushing phase

Question 10

name the pain management options that are safe during early labor phase

Answer 10

(1) non-pharm methods
(2) NO
(3) sedatives
(4) opioids
(5) epidural

Question 11

name the pain management options that are safe during active labor phase

Answer 11

(1) non-pharm methods
(2) NO
(3) opioids
(4) epidural

Question 12

name the pain management options that are safe during stage 2

Answer 12

(1) non-pharm methods
(2) NO
(3) local infiltration

Question 13

name the pain management options for stage 3

Answer 13

(1) non-pharm methods
(2) NO
(3) opioids
(4) local infiltration

Question 14

Name at least 3 non-pharm comfort measures

Answer 14

(1) heat/cold
(2) touch/massage
(3) psychosocial comfort
(4) hydrotherapy
(5) counterpressure
(6) knee press
(7) birth ball

Question 15

____ does not stay in the system after they stop inhaling the substance

Answer 15

Nitrous oxide

Question 16

sedatives such as ____ are used for ____

Answer 16

Vistaril; relaxation and sometimes sleep

Question 17

which opioid is most commonly used in early labor phase?

Answer 17

Morphine IM

Question 18

which opioid is more rapid-acting?

Answer 18

Fentanyl

Question 19

What happens if opioids are given too late in labor?

Answer 19

no relief and can cause neonatal respiratory depression

Question 20

what needs to be present when using opioids?

Answer 20

Narcan

Question 21

some pain relief and motor block

Answer 21

regional analgesia

Question 22

complete pain relief and motor block

Answer 22

regional anesthesia

Question 23

what is the primary use of local perineal infiltration anesthesia?

Answer 23

repair of perineal lacerations

Question 24

Use of needle guide and luer-lok syringe to inject medication

Answer 24

pudendal nerve block

Question 25

when can pudendal nerve block be used?

Answer 25

2nd and 3rd stages of labor

Question 26

spinal anesthesia is used during ___

Answer 26

c-section

Question 27

name the 2 advantages of spinal anesthesia for pregnant person

Answer 27

(1) awake and can participate in birth (2) retain airway reflex

Question 28

name at least 3 limitations of spinal anesthesia

Answer 28

(1) maternal hypotension (2) FHR changes (3) delayed respiratory depression (4) N/V (5) pruritus (6) urinary retention (7) spinal headache

Question 29

____ leads to reduced motor function from xiphoid process down to toes

Answer 29

spinal block

Question 30

Pts can typically have movement in legs - can’t walk, but there is still some ability with ____

Answer 30

epidural block

Question 31

Continuous infusion via catheter of anesthetic (Marcain) and opiate (Fentanyl) injected into the epidural space between L4 and L5

Answer 31

Epidural

Question 32

general anesthesia is reserved for ___

Answer 32

emergency situations i.e., STAT c-section

Question 33

name the postpartum pain management for NSVB

Answer 33

(1) analgesic PO (acetaminophen) (2) NSAID PO (ibuprofen) (3) topical comforts

Question 34

name the postpartum pain management for c-section delivery

Answer 34

(1) opioid analgesic PCA x24 hr; then PO (2) NSAID IV x24 hrs; then PO

Question 35

IV and PO _____ cannot be used at the same time

Answer 35

NSAIDs