Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Maternal-Newborn (Josh) > T2 - Mgmt of Discomforts PPT (Josh) > Flashcards

T2 - Mgmt of Discomforts PPT (Josh) Flashcards

1
Q

— is light stroking of abdomen or back in rhythm with the patient’s breathing during a contraction.

A

Effleurage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

— is steady pressure applied to sacral area…Especially helpful when back pain is caused by the baby in the occiput posterior position…

A

Counterpressure

***Lifts the occiput off the nerves and provides some relief.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the purpose of Controlled Breathing Techniques?

A

Provides distraction and reduces perception of pain during UC

In 1st Stage, it increases size of abdominal cavity and promotes fetal descent

In 2nd Stage, it assists in bearing down by increasing abdominal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How should they breathe?

A

iN through Nose

OUT through mOUTh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is the Pant-Blo breathing used?

A

8-10 cm

s/e: can cause hyperventilation and Resp Alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are S/E of Respiratory Alkalosis?

A

Lightheaded

Dizzy

Tingling of Fingers

Numbness/Blueness

***blow into paper bag or cupped hands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What breathing pattern is encouraged to reduce chance of Respiratory Alkalosis?

A

no more than 2 x’s the normal rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When would we give butorphanol (Stadol)?

A

at top of contraction to increase perfusion to mom and decrease to baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What determines the type of analgesia or anesthesia?

A

Stage/Phase and Progress of Labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why are Barbituates used?

A

to relieve anxiety and induce sleep

may be administers in early labor to alter a dysfunctional pattern

NOT used in active labor b/c of CNS depression in newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which class of drugs are NOT used?

A

Benzos

  • disrupt newborn thermal regulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Examples of Pure Opioids

A

Hydromorphine (Dilaudid)

Meperidine (Demerol)

Fentanyl (Sublimaze)

Sufentanil (Sufenta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Should Hydromorphine be given during labor?

A

Try NOT to give during active labor, but before is OK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Onset of — is almost immediate if given IV and 10-20 mins if IM.

A

Meperidine (Demerol)

***lasts 1.5 - 2 hrs

***not used as much b/c of effects on baby [sedation, neuro changes than can last 2-3 days]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When using Opioids, what should we have available for antidote?

A

Naloxone (Narcan)

***antagonist that reverses CNS depressant effects

***contraindicated for narcotic addicted patients b/c may precipitate withdrawal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of drug butorphanol tartrate (Stadol)?

A

Mixed Opioid Agonist-Antagonist

***Naloxone will NOT reverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which drugs provide adequate analgesia w/out respiratory depression in mom or baby?

A

Mixed Opioid Agonist-Antagonists

  • butorphanol tartrate (Stadol)
  • nalbuphine hydrochloride (Nubain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is one problem with Mixed Opiod Agonist-Antagonists like Stadol?

A

may precipitate withdrawal symptoms in narcotic dependent women and baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Advantages of Epidurals

A

Patient remains alert

Good relaxation is achieved

Only partial motor paralysis

Airway reflexes remain intact

Gastric emptying is not delayed

Blood loss is not excessive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Disadvantages of Epidural

A

Limited Mobility

May increase duration of 2nd stage of labor

Not effective for some patients

Urinary retention

Pruritus (ithcing)

High/Total Anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Epidural blocks are a combination of — and —-

A

-caine’s and opiods

22
Q

When would an Epidural be administered?

A

after labor is well established (5-7 cm)

23
Q

Where is the Epidural Space?

A

outside the dura mater b/t the dura and the Spinal Column

24
Q

Which vertebrae is the needle inserted through with an epidural?

A

L2-L5 (L3-L4 mostly)

25
Q

Benefits of Epidural?

A

Airway remains intact

Only partial motor paralysis

Gastric emptying NOT delayed

Blood loss NOT excessive

26
Q

Nursing actions w/ Epidural:

Why preload with IV fluids?

A

volume expansion to prevent maternal hypotension

expansion also increases size of epidural space

27
Q

Nursing actions w/ Epidural:

Which position for needle insertion?

A

modified Sims or upright w/ back curved and legs dangling from bedside

  • ‘Mad Cat’ or ‘Angry Shrimp’ position
28
Q

Nursing actions w/ Epidural:

After needle insertion, which position should client be placed in?

A

side lying

  • prevents supine hypotension
  • helps distribute med evenly
29
Q

Post Epidural Nursing Actions:

A

Assess maternal VS and FHR and O2 sat

Observe for bladder distention

Protect from injury

Assist woman to change position

Record response to meds

Monitor for adverse reactions

30
Q

Complications from Epidural

A

Accidental injection into subarachnoid space (High Spinal)

Significant Hypotension

Post dural puncture headache

Infection

31
Q

Why are High Spinals a concern?

A

can lead to respiratory arrest

32
Q

What should we do if mother has a Hypotensive Episode in response to epidural?

A

Turn to lateral position or wedge hip

Increase IV rate

O2 by facemask (10-12 L)

Eleveate client’s legs (10-20 degrees)

Call Doc

Be prepared to administer vasoconstrictors (Ephedrine)

33
Q

Nursing DX for Hypotensive Episode from Epidural.

A

Ineffective uteroplacental perfusion r/t maternal hypotension associated w/ epidural block meds

34
Q

When would we expect to see a post dural puncture headache?

A

2 days after puncture and may continue for weeks

35
Q

What causes relief from Post Dural Puncture Headache?

A

lie flat for 30 mins or less

36
Q

How do we fix the Post Dural Puncture Headache?

A

Epidural Blood Path

  • the most rapid, beneficial, and reliable relief measure for PDP headache
  • woman’s blood is injected into the epidural space which creates a clot that patches the tear
  • instantaneous pain relief
37
Q

Besides Epidural Blood Patch, what are other treatments for PDP Headache?

A

Bedreast (lying flat)

Increase CAFFEINE (Mountain Dew and Excedrin)

Fluids (Oral or IV)

38
Q

When is a Prudential Block used?

A

2nd and 3rd Stages of Labor and for repair of Episiotomy

***epidural block is suitable for all stages of labor and repair of episiotomy

39
Q

Diff b/t Prudential Block and Epidural Block?

A

Prudintial block just blocks prudential nerve to pernieal area

Epidural block blocks all below L2-L5

40
Q

When would a Prudential Block be administered?

A

late in 2nd stage of labor

***can also be administered during 3rd stage if episiotomy repair is necessary

41
Q

Benefits of Prudential Block?

A

Doesn’t affect hemodynamic or respiratory functions

Doesn’t affect VS

Doesn’t affect FHR

42
Q

What is a negative about Prudential Block?

A

urge to bear down is lessened or lost completely

no relief from UC (only for perineal area)

43
Q

Which type of Anestheisia is used for birth and post delivery repairs and NOT for labor?

A

Prudential Block

44
Q

What are advantages of a Spinal Block?

A

rapid pain relief w/o sedative effects

low incidence of adverse effects

45
Q

What would a spinal block be good for?

A

C-section

46
Q

Disadvantages of Spinal Block

A

Short duration

Postspinal headache

Increase incidence and degree of hypotension

Urine retention

47
Q

Local Infiltration of Pernieum:

Why would epinephrine be given along w/ a ‘caine’ med?

A

to prevent excessive bleeding from episiotomy by constricting blood vessels

48
Q

How is a Local Perineum injection given?

A

local anestetic (lidocaine) injected into skin and then SQ into region to be anesthetized

49
Q

When would a General Anesthetic be used?

A

only if regional is contraindicated or if emergency situation develops

50
Q

Fetal adverse reactions to General Anesthesia?

A

Resp. depression

Hypotonia

Lethargy

51
Q

Examples of Inhaled General Anesthetics?

A

Nitrous Oxide

Halothane

Fluothane

52
Q

Nursing actions w/ General Anesthesia

A

Oral antacids to neutralize gastric acid

Tilt the patient to displace uterus and keep IVC from being compressed

Maternal-Newborn (Josh) (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions