Promotion of Comfort Flashcards
what is the objective during the first stage of labor?
to know the patients pain goal and birth plan
ambulation (walking)
position changes
quiet envt
aromatherapy
acupressure
Non-pharmacologic measures to decrease pain
an upright position (walking, sitting, kneeling and squatting) promote what?
promotes descent of fetus
being on your hands and knees helps the fetus do what?
Helps the fetus rotate (LOP or ROP)
non-pharmacologic ways to assure comfort during the first stage of labor
birthing ball
peanut ball
bathtub
breathing techniques
heat or cold
massage
meditation
etc.
what is the key thing to remember about pharmacologic medications during labor?
Important to know that almost all pharmacologic medications gross the placenta and have some effect on fetus
the goal of pharmacologic pain management is
relax and relieve discomfort
not necessarily be “pain free”
common side effects of medication?
decreased oxygenation and decreased blood pressure
what is the National safety goals in regards to medication in labor?
Never give medication to
pregnant woman unless benefit outweighs risk
Common opioids used for childbirth
- Butorphanol tartate (Stadol)
- Nalbuphine (Nubain)
- Fentanyl (Sublimaze)
if you use an opioid for pain relief during labor what MUST be available, if needed.
Narcan
what is the time frame to give an opioid to a laboring mom
want at least 3 hours prior to delivery.
due to the metabolism in the fetus
what can opioids cause for mom and baby?
Can cause maternal respiratory depression and fetal CNS depression
what must be throughly checked (for fetus) if mom received an opioid during labor?
Respiratory status should be monitored in newborn
what are 2 common regional anesthesias
Bupivacaine
Chloroprocaine
where is an anesthetic agent placed?
epidural space
L4-L5
L3-L4
L2-L3
what is the goal for an epidural?
for the laboring mom to still be able to feel a contraction coming on so she is aware when to push for delivery BUT relieve the discomfort and pain of the contractions
in the laboring mom what is the most common side effect of an epidural?
hypotension
These are side effects of what pain management medicine?
Hypotension (blocking effect on sympathetic nerves) risk is reduced if well hydrated
◦ Intense pruritus; Spinal headaches are rare
◦ May prolong 2nd stage of labor (Adm. of oxytocin will shorten labor)
◦ Loss of sensation of bladder filling
◦ Effects on fetus
epidural
When and only when do we use Spinal anesthesia?
Cesarian Section delivery
when do we use General anesthesia as a pain blocker?
Cesarian Section delivery EMERGENCY
