Pain Flashcards
A laboring mother is very anxious, crying, and has a decreased perceptual field. You need her consent for the epidural. What should you do?
Wait until she calms down
What can influence pain perception
Childbirth education Cultural background Fatigue/lack of sleep Personal significance Anxiety Genetics Previous experiences Support
Does quietness mean there is no pain
No
What is effacement
Thinning of the cervical area
What are the three phases in the first stage of labor
Latent
Active
Transition
What phase of labor is the most painful in the first stage
Transition
What causes the pain during the first stage
Hypoxic uterine cells
Pressure-adjacent structures( due to child coming down through pelvis) distention of lower uterus
Dilation, effacement, stretching of uterus
When does the second stage of labor start
When mother is 10 cm dilated
What causes the pain in the second stage
Hypoxic uterine cells
Distention- vagina and perineum (child has to come through)
Pressure-adjacent structures
Lacerations
When does the third stage of labor begin
After child is born
What causes the pain during the third stage
Contractions (much less intense)
Cervical dilation
How long should it take for placenta to be delivers
5-30 ,minutes
If it takes longer they need to use a D&C (cervical scrapping) to get placenta out
What is the one thing that all non pharmacological pain management tools include
Education
What are the goals of breathing patterns
Oxygenate
Relaxation
Decrease pain and anxiety
Slow breathing to prevent hyperventilation
Lamaze
Mind prevention
Controlled breathing, toning, relaxation
Bradley
Partner coached
Slow controlled abdominal breathing
Teaching techniques directed towards coach vs mother
Dick-read
Believes fear built state of tension
Knowledge to decrease pain and abdominal breathing
Kitzinger
Strong believer in home births
Hypnobreathing
Hypnotized
Effleurage
Rhythmic stroking if abdomen during pain
What is sacral pressure
Back rubs during contractions
Should you encourage or discourage vocalization during labor?
Encourage
Can promote relaxation and help to relieve tension
What is the goal of analgesics during labor
Relieve pain
Minimal motor blockage
Use small amount possible because baby will get it too
What happens if analgesics are given too early?
Too late?
Early- May prolong labor
Late- little value and may cause neonatal respiratory depressions