Test 3 COPY Flashcards
What are 4 sources of labor pain
- Tissue Ischemia
- Cervical Dilation
- Pressure and pulling on pelvic structures
- Distention of Vagina and Perineum
Factors influencing perception or tolerance of pain?
- labor intensity
- Cervical readiness
- Fetal Position
- Pelvic readiness
- Fatigue & hunger
- Caregiver interventions
Advantages to non-pharmacologic pain management
- Non systemic
- Doesn’t effect fetus
- Doesn’t effect labor
- ## Non allergy contraindications
Psychosocial factors that influence labor pain include
- culture
- anxiety and fear
- previous experiences
- preparation for childbirth
- mother’s support system.
Excessive pain can heighten a woman’s fear and anxiety, which stimulates an increased secretion of ___________________.
Catecholamines
Catecholamines act on what two receptors?
- Alpha
- Beta
Stimulation of the ______ receptors relaxes the uterine muscle and cause __________
- Beta
- Vasodilation
Stimulation of the _________ receptors causes uterine and generalized ____________.
- Alpha
- Vasocontriction
What are the effects of excessive catecholamine secretion?
- Reduced blood flow to and from the placenta,
* Reduced effectiveness of uterine contractions, slowing labor progress
Pain is both physiologic and psychological. The Physiological pain can be affected by increased secretion of _____________
Catecholamines
Labor _______ a woman’s metabolic rate and her demand for __________.
- increases
- oxygen
How do pain and anxiety affect a woman’s already high metabolic rate.
Increase
How does an increase in metabolic rate affect the fetus?
- significantly alter placental exchange causing less oxygen to be available for the fetus
The fetus shifts to _____________ when it does not have enough oxygen available for uptake
Anaerobic Metabolism
The fetus may shift to _____________ when it does not have enough oxygen available for uptake
Anaerobic Metabolism
___________ acidosis and does not resolve as quickly after birth as __________ acidosis, which results from shorter periods of ___________.
- Metabolic
- Respiratory
- hypoxia
What are the psychological effects of poorly relieved pain?
- affect the mothers interaction with newborn as she is so depleted/tired
- Poor memories of
- Affect her response to sexual activity
What are 3 causes of pain in labor in stage 1?
- Stretching of the cervix
- Uterine Anoxia - Tissue ischemia
- Stretching of the uterine ligaments
What are 4 causes of pain in labor in stage 2 ?
- Traction on the stretching of perineum
- Distention of the vagina and perineum
- Compression of the nerve ganglia in cervix and lower uterus
- Pressure on urethra, bladder & rectum during fetus decent
What factors that influence perception and tolerance of pain
- Labor intensity
- Cervix that is not ready results in longer labor which leads to lowered level of pain tolerance
- Fetal position such as posterior is more painful
- Pelvic readiness - abnormal pelvis
- Fatigue and Hunger reduce a woman’s ability to tolerate pain
- Interventions by medical personnel
Goal of pain management?
- Help ease the anxiety in the moment of labor
Sedatives are given to …
- promote sedation and relaxation
Benefits of Sedatives
- promote sedation and relaxation
- Decrease release of catecholamines
Adverse effects of Epidural block
- Maternal hypotension
- Bladder distention
- Catheter migration
- Cesarean Birth