exam 2 management of discomfort Flashcards

Question

what are the insertion techniques?

Answer 1

Preload with IV fluids _ volume expansion to prevent maternal hypotension Position in modified Sims or upright with back curved and legs dangling from bedside After insertion assist to alternate side lying positions (Prevents supine hypotension and Helps distribute medication evenly)

Answer 2

Assess maternal VS and FHR and O2 sat (protocol) Assist woman to change position using pillows to prop if necessary observe for bladder distention protect from injury record the response monitor for adverse or allergic reactions *Preloaded with IV fluid for blood volume expansion to prevent maternal hypotension Assist client to assume and maintain position (sitting or side-lying) during the procedure Monitor for bladder distention and measure urinary output to ensure bladder is completely emptied*

Answer 3

accidental injection of epidural dose in the subarachnoid space --> "high spinal" Watch for Maternal hypotension --> decreased placental perfusion --> non-reassuring FHR pattern Significant maternal hypotension --> to newborn endangerment post dural puncture HA infection A test dose will be given to assess for intravascular injection. S/s include increased heart rate, numbness tingling of mouth, ringing in ears, disorientation, excitation, and bizarre behavior -High Spinals can lead to respiratory arrest -fever can be related to thermoregulatory changes and or infection

Answer 4

turn to lateral position or wedge hip increase IV infusion rate O2 by face mask at 10-12 L/M evaluate clients legs (10-20 degrees) alert DR be prepared to admin vasoconstrictor drugs (ephedrine) per order (ex: systolic BP falls below 100)

Answer 5

May be seen within 2 days of puncture but may continue for days to weeks - Assuming an upright position intensifies headache - Lying flat for 30 minutes or less results in relief of headache -Headache can be accompanied by blurred vision, ringing in the ears, and/or light sensitivity

Answer 6

The most rapid, beneficial, and reliable relief measure for PDP headache The woman’s blood is injected into the epidural space which creates a clot that patches the tear or hole Pain relief can be almost instantaneous *Other treatment options can be bedrest, lying flat, increased caffeine intake, some practitioners use Mountain Dew and Excedrin Migraine, which has a high caffeine level. Oral or IV fluids can also be administered. 10 to 20 ml of blood is injected into the lumbar space and patches the hole in the dura mater.*

Answer 7

A. Pudendal block; suitable during second and third stages of labor and for repair of episiotomy B. Epidural block; suitable during all stages of labor and for repair of episiotomy

Answer 8

blockage of pudendal nerve used for birth and post delivery repairs, NOT LABOR doesn't depress fetus no relief from uterine contractions; only from perineum distention.

Answer 9

Injection of medication into the CSF in spinal canal Advantages: Rapid pain relief without sedation (useful for urgent cesarean births) and Low incidence of adverse effects Small gauge needle can reduce likelihood of post spinal headache Position flat X 8 hours

Answer 10

Injection of medication into the CSF in spinal canal Advantages: Rapid pain relief without sedation (useful for urgent cesarean births) and Low incidence of adverse effects Small gauge needle can reduce likelihood of post spinal headache Position flat X 8 hours

Answer 11

short duration of action post spinal HA r/t leakage of CSF increased incidence and degree of hypotension urine retention

Answer 12

used frequently for episiotomy epi added to "caine" drug to prevent excessive bleeding by constricting blood vessels does not affect pain of uterine contractions no adverse fetal, newborn, or maternal effects. Local anesthetic (i.e.. Lidocaine) injected into the skin and then SQ into region to be anesthetized (episiotomy or repair of laceration)

Answer 13

Used only if regional anesthesia is contraindicated or if an emergency situation develops suddenly Inhaled anesthetics include nitrous oxide, Halothane, and Fluothane Fetal adverse reactions include respiratory depression, hypotonia and lethargy *Oral antacid given if time (Alka-Seltzer Gold or Bicetra) neutralizes the gastric acids in the stomach. Anesthesia may also give Reglan, Pepcid or Zantac IV* *Tilt the patient – displaces the uterus keeping the Aorta & vena cava from being compressed = good placental flow & cardiac output*