Module 6pt2,7&8 BBB

Question 1

How do epidural affect second stage?

Answer 1

Increases the length of second stage and occurrence of operative delivery

Question 2

What IV medication should be considered as potentially the most dangerous to use in labor? Why?

Answer 2

Demerol-it has a long half-life and can affect baby’s breathing at birth

Question 3

When would you want to avoid nubain or stadol? Why?

Answer 3

Patients who are receiving opioid agonist therapy. It can trigger withdrawal.

Question 4

What is the reflex that is happening when the patient has the urge to push? What causes it?

Answer 4

The Ferguson reflex. When the head comes down to +1, there is a surge of oxytocin that causes an urge to push

Question 5

Does every patient feel an urge to push?

Answer 5

No, esp with an epidural, they may never feel an urge.

Question 6

Does the evidence support physiologic or medical labor more? Aka when to push?

Answer 6

No, there is no clear evidence that it does or does not cause harm. There is just anecdotal evidence

Question 7

What type of pushing does the evidence support?

Answer 7

Open glottis pushing shows a decrease in fetal heart rate abnormalities and additional problems

Question 8

Is position preference of the provider or patient more important if all is WNL?

Answer 8

Patient