Intrapartum Pain

Question 1

Intrapartum pain is a subjective experience of physical
sensations associated with

Answer 1

with uterine contractions, cervical
dilation and effacement, and fetal descent during labor and
birth

Question 2

Physiologic responses to pain may include increased

Answer 2

increased blood
pressure, pulse , respirations, perspirations, pupil diameter,
muscle tension (e.g. facial tension or fisted hands) or muscle
activity (e.g. pacing, turning, or twisting).

Question 3

Nonverbal expressions of pain may include

Answer 3

withdrawal,
hostility, fear, or depression

Question 4

Verbal expression of pain may include

Answer 4

statements of pain,
moaning, and groaning.

Question 5

Intrapartum Pain Experience:
Factors affecting perception of intrapartum pain

Answer 5

Previous experience with pain
personal expectations

Cultural concept of pain

Rapidly progressive uterine
contraction
Fear, anxiety, and fatigue

Question 6

Intrapartum Pain Experience:

Physiologic causes of intrapartum pain

Uterine ____ due to compressed muscle cells during the contraction

Answer 6

anoxia

Question 7

Compression of the ____ in the ___ and ____ t during the contraction

Answer 7

nerve ganglia

cervix

lower uterine segment

Question 8

The two goals of intrapartum pain management are:

Answer 8

(a) To provide maximal relief of pain with maximal safety for the mother and fetus
(b) To facilitate labor and delivery as a positive family experience

Question 9

2) Pain relief may be achieved by using prepared childbirth methods

Answer 9

(e.g. Lamaze), analgesics, or regional anesthetics.

Question 10

3) Intervention for pain relief during labor depends on the following factors

Answer 10

Gestational age of the fetus

Frequency, duration, and intensity of the contraction

Labor progress
Maternal response to pain and labor

Allergies and sensitivities to analgesics and anesthetics

Question 11

Nonpharmacologic pain management

Prepared childbirth methods can help the client feel more in control and relaxed, helping her “work with” the contractions; it may shorten labor
_____ may be useful in some clients.

Answer 11

Hypnosis

Question 12

Intrapartum Pain Experience: Nonpharmacologic pain management

Interventions aimed at supporting the client during labor may be helpful. These include:

Answer 12

a) Providing information about the progress of labor
b) Reinforcing techniques learned in prepared childbirth classes.
c) Directing breathing methods, abdominal lifting, pushing, relieving external pressure, distraction, cutaneous stimulation, and relaxation.

Question 13

Intrapartum Pain Experience: Pharmacologic pain management

1

Answer 13

. Narcotic analgesics

Question 14

. Narcotic analgesics EFFECTS

Answer 14

depressive effects on the neonate occurring 2 to 3 hours after intramuscular injection

MATERNAL
nausea, vomiting, mild respiratory depression, and transient mental impairment.

FETAL;
are reduced fetal heart rate (FHR) and decreased variability, neonatal effects are lowered Apgar score and respiratory depression.

Question 15

Intrapartum Pain Experience: Pharmacologic pain management

narcotic analgesics

must be readily available in case of respiratory depression in the mother or newborn.

Answer 15

Narcotic antagonists (i.e. naloxone (Narcan

Question 16

Intrapartum Pain Experience: Pharmacologic pain management

The decision to administer a narcotic analgesic is based on the results of a

Answer 16

vaginal examination

Question 17

the risk of ____ may preclude the use of analgesics.

Answer 17

neonatal narcosis

Question 18

Intrapartum Pain Experience: Pharmacologic pain management
NUMBER 2

Answer 18

. Barbiturates

Question 19

Maternal side effects of barbiturates include

Answer 19

nausea, vomiting, hypotension, restlessness, and vertigo.

Question 20

Neonatal side effects of barbiturates include

Answer 20

central nervous system depression, prolonged drowsiness, and delayed establishment of feeding

Question 21

Intrapartum Pain Experience: Pharmacologic pain management
NUMBER 3

Answer 21

Tranquilizers

Question 22

Maternal side effect associated with tranquilizers include

Answer 22

hypotension (which, in turn, decreases fetoplacental circulation), drowsiness, and dizziness.

Question 23

Fetal effects associated with tranquilizers include

Answer 23

tachycardia and the loss of normal beat-to-beat variability on electronic fetal heart monitoring

Question 24

Newborn effects associated with tranquilizers include

Answer 24

hypotonia, hypothermia, generalized drowsiness, and a reluctance to feed for the first few days.

Question 25

Intrapartum Pain Experience: Pharmacologic pain management
NUMBER 4

Answer 25

. Regional anesthesia (conduction anesthesia

Question 26

Types of regional anesthesia include

Answer 26

spinal block, epidural, paracervical, pudendal block, and local infiltration.

Question 27

Regional anesthesia Adverse reactions may include

Answer 27

maternal hypotension, allergic or toxic reaction, respiratory paralysis, and partial or total anesthetic failure.

Question 28

Intrapartum Pain Experience: Pharmacologic pain management|
NUMBER 5

Answer 28

. General anesthesia

Question 29

Physiologic Causes of Intrapartum Pain

Answer 29

Uterine anoxia

Compression of the nerve ganglia

Stretching of the cervix

Traction on

Pressure on organs

Distention

stretching

Question 30

General anesthesia

(inhalant
and
intravenous

Answer 30

[e.g. nitrous oxide and
halothane]

[e.g. Pentothal])

Question 31

General anesthesia

Answer 31

usually is used during childbirth only if an emergency
cesarean section becomes necessary.

Question 32

The intrapartum period extends from the

Answer 32

e beginning of
contractions that cause cervical dilation to the first 1
to 4 hours after delivery of the newborn and placenta

Question 33

Intrapartum Care

Answer 33

refers to the medical and nursing care given to a
pregnant woman and her family during labor and
delivery