Sensation Flashcards
Common Discomforts: 1st Trimester
1) Nausea & vomiting 🤮
- avoid odor, eat crackers, 🚫 greasy seasoned foods, drinks fluids between meals & carbonated drinks, small freq meals acupressure wrist bands
2) Urinary Frequency
- increase fluid intake during day & decrease in evening, void when urge is present
3) Fatigue
- plan rest periods, go to bed earlier, ask for support from family
4) Nasal Stuffiness & Epistaxis(👃🏼 🩸 )
- use cool mist vaporizer
5) Breast Tenderness
- wear well supportive bra
6) Increased Vaginal Discharge
- wash daily and wear cotton underwear 🩲
7) Ptyalism (dry 👄 )
- mouth wash, chew gum & hard 🍭
Common Discomforts: 2nd – 3rd Trimesters
1) Heartburn ❤️🔥
- small freq meals, 🚫 over eating or laying down after meal, low sodium antacid
2) Ankle edema
- worse w/ prolong stand or sitting, elevate feet, dorsiflex 🦶🏻 freq
3) Varicose veins
- elevate legs as much as possible, wear support hose, 🚫 crossing at knees/standing for long periods
4) Hemorrhoids
- avoid constipation, 🧊, sitz bath
5) Constipation
- ⬆️ fluid and fiber, develop reg bowel habits, stool softener, exercise
6) Backache
- use good body movement, pelvic tilt, no high heels 👠
7) Difficulty sleeping
- try diff positions, sleep aid from doctors
8) Leg Cramps
- apply heat to muscles
9) Faintness
- check for anemia, change positions slowly, avoid standing long
10) Dyspnea
- good posture, sleep semi fowlers/ propped with pillows
11) Flatulence
12) Carpal Tunnel Syndrome
- avoid repetitive hand movements, elevate arms
13) Round Ligament Pain
- heating pad, avoid gas forming foods, exercise
Adverse Effects of Excessive Pain
Physiologic effects
●Increase in metabolic rate and oxygen demand
●Less oxygen/waste exchange for fetus
Psychological effects
●Difficulty interacting with the infant
●Unpleasant memories
●Partner may feel inadequate
Sources of Pain
●Tissue Ischemia
●Cervical Dilation
●Pressure & Pulling on Pelvic Structures
●Distention of the Vagina & Perineum
Factors Influencing the Perception of Pain
Physical & Psychosocial
Physical influences ●Intensity of labor ●Fetal position and size ●Characteristics of the pelvis ●Fatigue ●Intervention of caregivers
Psychosocial factors ●Culture ●Anxiety and fear ●Previous experiences with pain ●Preparation for childbirth ●Support systems
Pharmacologic Pain Management
●Anesthesia encompasses analgesia, amnesia, relaxation, and reflex activity.
●Analgesia: the alleviation of the sensation of pain or the raising of the threshold for pain perception without loss of consciousness
- type of analgesic or anesthetic chosen is determined in part by the stage of labor of the woman and by the method of birth planned
Adverse Effects of Epidural Block & Opioids
epidural block ●Maternal hypotension ●Bladder distortion ●Migration of epidural catheter ●Fever
epidural opioids
●Nausea and vomiting
●Pruritis
Maternal hypotension
- poor perfusion to baby (fetal bradycardia)
Sedatives
●Relieve anxiety and induce sleep; typically used for women in a prolonged latent phase of labor when there is a need to lessen the intensity of the contractions, decrease anxiety, or promote sleep
●Barbiturates
●Phenothiazines
●Benzodiazepines
Meperidine (Demerol)
- feeling of well-being, no amnesic effect
- May aid progress as cervical relaxation occurs
- Will halt labor contractions if given too early
- Avoid use when close to delivery (about 1 hour)
- Usually given b/n 4-7 cm’s
Side effects:
- CNS depression
- Neonatal respiratory depression
Butorphanol (Stadol)
Nalbuphine (Nubain)
Opioid agonist-antagonist:
*Moderate to severe labor pain and postop pain after c/s
No respiratory depression in woman or neonate
Side effects
*Confusion, sedation, hallucinations, “floating” feeling, dizziness
- Check maternal history for drug abuse
- Do not give to drug dependent woman due to possible precipitation of sudden withdrawal response in woman and baby
- Encourage voiding q 2 hrs
Nursing responsibilities for Analgesic Meds
What to asses?
When to give?
- Assess FHR, maternal VS, and cervical status prior to and after administration
- Give analgesics at peak of contraction so less medication will transfer to baby
- Assess for effectiveness/side effects
- Provide safety, especially if LOC expected to be altered
Narcotic reversal
Naloxone Hydrochloride (Narcan)
can be used for mom or neonate to reduce respiratory depression associated with opiates
Pain relief
Massage (counter pressure)
Shower
Relaxation
Breathing techniques
Regional anesthesia-
Epidural- spine
- xlocaine & fentanyl
Pudendal Nerve block (local anesthesia) for those who don’t get epidural, done during second stage of labor
- xlocaine drug of choice
