Intrapartum Pain Flashcards
Intrapartum pain is a subjective experience of physical
sensations associated with
with uterine contractions, cervical
dilation and effacement, and fetal descent during labor and
birth
Physiologic responses to pain may include increased
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).
Nonverbal expressions of pain may include
withdrawal,
hostility, fear, or depression
Verbal expression of pain may include
statements of pain,
moaning, and groaning.
Intrapartum Pain Experience:
Factors affecting perception of intrapartum pain
Previous experience with pain
personal expectations
Cultural concept of pain
Rapidly progressive uterine
contraction
Fear, anxiety, and fatigue
Intrapartum Pain Experience: Physiologic causes of intrapartum pain
Uterine ____ due to compressed muscle cells during the contraction
anoxia
of the nerve ganglia in the cervix and lower uterine segment during the contraction
Compression
The two goals of intrapartum pain management are:
(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
2) Pain relief may be achieved by using prepared childbirth methods
(e.g. Lamaze), analgesics, or regional anesthetics.
3) Intervention for pain relief during labor depends on the following factors
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
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.
Hypnosis
Intrapartum Pain Experience: Nonpharmacologic pain management
Interventions aimed at supporting the client during labor may be helpful. These include:
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.
Intrapartum Pain Experience: Pharmacologic pain management
. Narcotic analgesics
. Narcotic analgesics EFFECTS
depressive effects on the neonate occurring 2 to 3 hours after intramuscular injection
nausea, vomiting, mild respiratory depression, and transient mental impairment.
are reduced fetal heart rate (FHR) and decreased variability, neonatal effects are lowered Apgar score and respiratory depression.
Intrapartum Pain Experience: Pharmacologic pain management
must be readily available in case of respiratory depression in the mother or newborn.
Narcotic antagonists (i.e. naloxone (Narcan
