Exam 4: Chapter 17 Max comfort for Laboring Woman

Question 1

Cultural consideration for Chinese women during labor

Answer 1

may not exhibit relations to pain, although exhibiting pain during childbirth is acceptable.

• pain interventions must be offered more than once.
• Acupuncture may be used.
• Assess for pain

Question 2

Arab or middle Eastern women

Answer 2

• may be vocal in the response to labor pain.

- they may prefer medication for pain relief

Question 3

Japanese woman

Answer 3

• stoic in response to labor pain

- may request medication when pain is severe

Question 4

Southeast Asia woman

Answer 4

-may endure severe pain before requesting medication

Question 5

Hispanic woman

Answer 5

-may be stoic until late labor, when they become vocal and request pain relief

Question 6

Native-American woman

Answer 6

• may use medications or remedies made from indigenous plants.
• stoic in the response to labor pain

Question 7

African -American woman

Answer 7

• may express pain openly

- use of pain relief varies

Question 8

Expression of pain

Answer 8

• BP and R increase
• hyperventilation
• Respiratory alkalosis
• Pallor and diaphoresis
• gastric acidity: N/V

-increased anxiety

Question 9

Spinal anesthesia (block)

Answer 9

can be given in second stage of labor, vaginal birth, and C-section

-higher in back; puncture cerebral spinal sac; wet tap!

Question 10

Fentanyl Citrate (Sublimaze) or sufentanil Citrate (Sufenta)

Answer 10

Spinal anesthesia (block)

• primarily in C-section: nipples to feet
• vaginal: hips to feet

-Position: sitting or lying on side (modified sims) with back curved (widens intervertebral space)

Question 11

Epidural blood

Answer 11

➢ Her blood (20mL) is injected slowly into the lumbar space, creating a clot that patches the tear or hole in the dura mater around the spinal cord.
➢ Considered after noninvasive techniques have failed.
➢ Spinal headache: set up for epidural again. Go into epidural space, but do not instill medication, draw peripheral blood from arm in syringe and this is used to form a clot over the opening to stop the leakage to get back equilibrium and relieve cerebral spinal headache. Drugs won’t cure headache

Question 12

o Position: sitting or lying on side (modified sims) with back curved (widens intervertebral space)

Answer 12

spinal anesthesia (block)

Question 13

Epidural anesthisia

Answer 13

injection between 4-5 lumbar space.

most effective
-does not puncture cerebral spinal canal. DON’T want a wet tap!

Question 14

Side effects of epidural and spinal anesthesia

Answer 14

• hypotension: decreased placental perfusion
• High total spinal anesthesia
• Fever
• Urinary retention
• Pruritus (itching)
• Limited movement
• Longer second stage of labor
• Increased use of oxytocin
• INcreased liklihood of forceps- or vacuum assisted birth

Question 15

Local anesthetic toxicity

Answer 15

• lightheadedness
• dizziness
• Tinnitus (ringing in the ears)
• Metallic taste
• Numbness of the tongue and mouth
• Bizarre behavior
• Slurred speech
• Convulsions
• oss of consciousness