Wk 8 Comfort: Intrapartum

Question 1

Sources of pain

Answer 1

Tissue ishemia
Cervical dilation
Pressure and pulling on the pelvic structures
Distention of the vagina and perineum

Question 2

Nonpharmacological interventions

Answer 2

General comfort
Reducing anxiety and fear
Promoting relaxation
Mind/body stimulation (massage, thermal, acupressure)

Question 3

Types of pharmacological intervenetion

Answer 3

Reginal anesthesia- injection near a cluster of nerves to numb the area of your body that requires surgery

Pudendal block (aka saddle block)- local anesthesia relieve pain during the delivery of baby by forceps

Local anesthesia

Epidural block- given after active labor is established, L3-L5 space

Opioid analgesics

Question 4

Epidural complications

Answer 4

Maternal hypotension
Bladder distention
Prolonged second stage of labor
Fever
Respiratory depression
Migration of the epidural catheter
N/V

Question 5

Opioid analgesics

Answer 5

Meperidine (Demerol)
Fentanyl (Sublimaze)
Butorphanol (Stadol used to be the brand name)
Nalbuphine (Nubain)
Morphine Sulfate

Question 6

Adjunctive drugs (used for side effects)

Answer 6

Metochlopramide (Reglan)- nausea
Ondansetron (Zofran)- nausea
Diphenhydramine (Benadryl)- itching

Question 7

LAS stages (local adaptation syndrome)

Answer 7

Alarm- tissue injury such as tear, episiotomy, abdominal incision, redness, edema, ecchymosis, drainage.

Resistance- decreased erythema and edema. No drainage. Edges approximated

Exhaustion- wound/injured tissue is not healing

Question 8

PGAS stages (psychological general adaptation syndrome)

Answer 8

Alarm- anxiety/fear about labor and delivery can greatly affect the level of pain experiencing

Resistance- use of coping mechanisms and interventions to deal with pain

Exhaustion or recover- were the interventions effect in controlling pain or will the patient experience exhaustion and spiral out of control