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Nursing Management of Pain During Labor and Birth

Effleurage
stroking of the abdomen, thighs or other body parts
Endorphins
internal substances similar to morphine
Focal Point
intense concentration on an object
Pain Threshold
least amount of stimulation that aperson perceives as painful
Pain Tolerance
maximum amount of pain one is willing to bear
Four physical factors that cause pain during labor
dilation and stretching of the cervix, reduced uterine blood supply during contractions, pressure of the fetus on pelvic structures, stretching of the vagina and perineum
Cervical Readiness
changes that facilitate effacement and dilation in labor
Pelvic size and shape
abnormalities can result in a longer labor and greater maternal fatigue
Labor intensity
short, intense laobr often experiences more pain than the woman whose birth process is more gradual
Maternal Fatigue
reduces pain tolerance
Fetal Presentation and position
a wedge to efface and dilate teh cervix as each contraction pushes it downward
Education about expected changes
contribute to good outcomes
Conditioning exercise
prepare muscles for the demands of birth
Promoting a woman’s relaxation during labor is essential to any tyupe of pain management because
it consciously relaxes despite the deliberate pain
Reasons why it is useful for any laboring woman to know nonpharmacologic pain control methods
decrease fear and anxiety, reduces the pleasure of this extraordinary experience
Why promoting a woman’s relaxation during labor is essential to any type of pain management
it consciously relaxes despite the deliberate pain
Ways to help the laboring woman relax
adjust enviornment, water in a tub or shower, massage area
Hyperventilation
breathe slowly, and into cupped hands
Anesthesiologist
a physcian who specializes in giving anesthesia
Certified registered nurse anesthetist
a registered nurse who has advanced training in anesthetic administration
Why is it usually best t o avoid opioid narcotic analgesics if birth is anticipated within 1 hour of administration
can cause respiratory depression and sedation in newborn
What is the purpose of narcan
acts within minyutes to help resuscitage a newborn who has respiratory depression. So take VS
Which technique should be most helpful in interrupting transmission of labor pain to the brain
focusing on a point in the room
Choose the best method during the admission process to help relieve general anxiety for a woman having her first baby who has not attended prepared childbirth classes
give simple explanations about her enviornment and what to expect during labor
Butorphanol differs from meperidine in that butorphanol
better reduces teh pain of late labor
The newborn of a woman who receives narcotic analgesics during labor should be observed primarily for
slow respirations
A woman asks if she should take prepared childbirth classes. The best response of the nurse is to tell her that classes will
provide methods to help her cope with labor
Th prepared childbirth technique that is most likely to relieve back pain during labor is
sacral pressure
A woman is using prepared childbirth breathing techniques and complains of dizziness and tingling. the nurse should
tell her to exhale slowly into her cupped hands
Types of Anesthesia for childbirth
anesthetic method, local infiltration, pudendal block, epidural block, subarachnoid block, general anesthesia
Signs and symptoms of hyperventilation
dizziness, tingling of hands and feet, cramps and muscle spasms of hands, numbness around nose and mouth, blurring of vision
Ways to correct hyperventilation
breathe slowly, breathe into cupped hands, place a moist washcloth over the mouth and nose while breathing, hold breath for a few seconds before exhaling
The meninges around the spinal cord
dura mater, arachnoid mater, pia mater
The nurse should observe the woman who received epidural opioid narcotics for
late respiratory depression
Types of education classes available
gestational diabetes mellitus, early pregnancy, exercise for pregnant women, infant care, breastfeeding, sibling, grandparent, adolescent childbirth
Variations of Basic childbirth preparation classes
refresher, cesarean birth, vaginal birth after cesarean
Content of Childbirth Preparation Classes
benefits of exercise, pain control for labor
How childbirth pain differs from other pain
part of a normal birth process, woman has several months to prepare for pain management, is self-limiting and rapidly declines after birth
Factors that influence labor pain
pain threshold, sources of pain during labor, central nervous system’s factors, maternal conditions, fetal presentation and position
Central nervous system’s factors
gate control theory, endorphins
Maternal conditions
cervical readiness, pelvis, albor intensity, fatigue
Methods of childbirth preparation
dick-read, bradley, lamaze
Nonpharmacological pain relief measures
progressive relaxation, neuromuscular dissociation, touch relaxation, relaxation against pain, effleurage, sacral pressure, thermal stimulation, positioning, diversion and distraction, hydrotherapy
Breathing
first, second stage
First stage breathing
slow-paced, modified paced, patterned paced
Signs and symptoms of hyperventilation
dizziness, tingling of hands and feet, cramps and muscle spasms of hands, numbness around nose and mouth, blurring of vision
Corrective measures of hyperventilation
breathe slowly, especially when exhaling, breathe into cupped hands, place a moist washcloth over the mouth and nose while breathing, hold breath for a frew seconds before exhaling
Don’t interfere when
a woman is successfully using a sfafe, nonpharmacological pain control technique
Analgesics and adjunctive drugs
narcotic, narcotic antagonist, adjuntive drugs
Meninges around the spinal cord
dura mater, arachnoid mater, pia mater
Types of anesthesia for childbirth
anestetic, local infiltration, pudendal block, epidural block, subarachonoid block, general anestesia

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