OB_ Chapter 16 - Sheet1 Flashcards
What happens when analgesic meds are given in the active phase of labor?
Analgesic medications tend to speed up labor.
What happens when analgesic meds are given in the 2nd stage of labor?
Epidurals can slow progress and may result in more instrumentation or cesarean births.
What are the risks of opioid (narcotic) analgesics during labor?
Opioids can cause respiratory depression and fetal CNS depression. Timing is critical: <3 cm can slow labor, given too close to birth can cause a lethargic, sleepy baby.
When should opioids be given during labor?
Preferably when the patient is more than 3 hours away from birth to minimize neonatal sedation.
What are some common opioids used for pain relief during labor?
Nubain, Sublimaze, Stadol, Demerol.
What should be available when opioids are given during labor?
Narcan (narcotic agonist) should be available for administration to the infant at birth, as needed.
What is the chief concern with regional (local) anesthesia during labor?
The chief concern is its tendency to cause hypotension.
What should be done if hypotension occurs during regional anesthesia?
Raise the patient’s legs, administer O2, and IV fluids.
What is a disadvantage of epidural anesthesia?
It can reduce the bearing-down reflex, making it difficult to push effectively. This may delay fetal descent and prolong the second stage of labor, leading to an increase in instrument-assisted or cesarean births.
What are nursing actions for regional anesthesia?
- Encourage position changes to facilitate labor progression.-all fours, turn them around
-allow the epidural to wear off to help with urge to push
-give oxytocin iv to make contractions stronger
What is the aftercare for a patient with epidural anesthesia?
Ensure the patient lies on their side or, if on their back, place a firm towel under their hip to avoid supine hypotensive syndrome. Remind the patient to void every 2 hours, as the epidural may cause loss of sensation in bladder filling.
