Week 3- Pain Management Flashcards
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Lamaze “You don’t need anything”
Convince yourself there is no pain
Through distracting activities
1850’s
No pain medication for labor!
Visceral Pain
Cervical changes Distention of lower uterine segment Uterine ischemia Back pain Touching hurts!
Somatic Pain
Sharp, burning
Can point to
Intense
Well localized
Referred Pain
Originates from the uterus
Radiates from the abdominal wall
Expression of Pain
Increase anxiety➡️ pain ➡️ tense up
Cycle repeats
Withering, crying, groaning, clenching, muscular excitability
Factors Influencing Pain
PREVIOUS EXPERIENCE
Culture, anxiety, control of pain, comfort, support, environment
Posterior position is very painful!
Nonpharmacological
Simple, safe, inexpensive
Mother feels more in control
Practice, practice, practice
Try a variety of methods
Dule
A person who stays with the mother during labor
Trained to be a supporter
Increasing in popularity
Not a nurse/midwife
Effeurage
A light touch
At 1-3 cm
Practice breathing like you are blowing a candle out
Comfort Measures
Massage, tennis ball on back, cool wash cloth, ice chips
Diet during labor
NPO, incase of a c section
In between contractions
Turning from side to side
Change blue pad if necessary
Counter pressure
Tennis ball on back
Clenching hands
Relaxing and breathing techniques
Acupressure, acupuncture Heat or cool application Touch or massage Hypnosis Biofeedback- you're doing great! Aromatherapy Water block
Epidural
A spinal that doesn’t go all the way through
Numbs the mom
Can’t walk
Wears off sooner than a spinal
Pudendal Lock
Squirt anesthesia Works well but hurts! BP too low is a concern Not given often Local around the cervix
Spinal Anesthesia Block
Disadvantages: marked hypotension, impaired placental perfusion, ineffective breathing pattern, headache
Epidural Administration
Sitting down
Have to stay perfectly still!
Walking Epidural
Not a lot of anesthesia given
Can still walk around
To take away the pain you won’t be able to walk
Nerve block anesthesia
Little to no effect on the fetus
General Anesthesia
Rarely for vaginal births
Infrequently for c section
For indications of a necessary rapid birth
For emergency situations
Epidural can become a spinal
Can get the baby out in 1 min
Normally can get the baby out in 3
C section Anesthesia
Given a spinal
Informed consent
Consent preferred by patient
Can be a significant other
OR Crew
On call
Stat c section in less than 10-15 minutes
