Ch 17 Maximizing Comfort for the Laboring Woman (Exam 2, study guide)

Question 1

abolition of pain perception by interrupting nerve impulses to the brain.
- loss of sensation (partial or complete) and sometimes loss of consciousness occurs

Answer 1

anesthesia

Question 2

method used to repair a tear or hole in the dura mater around the spinal cord as a result of spinal anesthesia.
- the goal is to prevent or treat postdural puncture headache (PDPH)

Answer 2

autologous epidural blood patch

Question 3

single-injection, subarachnoid anesthesia useful for pain control during vaginal or cesarean birth (but not for labor)

Answer 3

spinal block (anesthesia)

Question 4

systemic analgesic, such as nalbuphine, that relieves pain without causing significant maternal or neonatal respiratory depression (is also less likely to cause N/V)

Answer 4

opioid agonist-antagonist analgesic

Question 5

provides rapid perineal anesthesia for performing and repairing an episiotomy or lacerations

Answer 5

local perineal infiltration anesthesia

Question 6

anesthetic gas mixed with oxygen, which is inhaled as soon as a contraction begins and meant to reduce, but not eliminate, pain during the first and second stages of labor

Answer 6

nitrous oxide

Question 7

injection of an opioid agonist analgesic into the spinal fluid to relieve pain associated with labor and following cesarean birth

Answer 7

intrathecal analgesia

Question 8

class of drug used to decrease anxiety, increase sedation, and reduce N/V, but may impair the analgesic efficacy of opioids

Answer 8

phenothiazine

Question 9

drug that promptly reverses the effects of opioids, including maternal and neonatal CNS depression, especially respiratory depression

Answer 9

opioid antagonist (narcan)

Question 10

systemic analgesic such as meperidine or fentanyl that relieves pain and create a feeling of well-being but can result in respiratory depression, N/V

Answer 10

opioid agonist analgesic

Question 11

alleviation of pain sensation or raising of the threshold for pain perception without loss of consciousness

Answer 11

analgesia

Question 12

relief from pain of UC and birth by injecting a local anesthetic agent and/or an opioid agonist analgesic into the peridural space

Answer 12

epidural block (analgesia/anesthesia)

Question 13

relief from pain in the lower vagina, vulva, and perineum, making it useful if an episiotomy is to be performed or forceps/vacuum assistance is required to facilitate birth

Answer 13

pudendal nerve block

Question 14

type of pain that predominates during the first stage of labor and is located over the lower abdomen
- it results from cervical changes, distention of the lower uterine segment, uterine ischemia, and pressure and traction on adjacent structures

Answer 14

visceral pain
(pain related to the internal organs in the midline of the body)

Question 15

type of intense, sharp, burning pain that predominates during the second stage of labor
Results from:
- stretching and distention of perineal tissues and the pelvic floor to allow passage of the fetus
- distention and traction on the peritoneal and uterocervical supports during contractions
- lacerations of soft tissues
- pressure against bladder and rectum

Answer 15

somatic pain
(pain that occurs in the tissues, such as muscles, skin, or joints)

Question 16

type of pain felt in areas of the body other that the area of pain origin
- during labor and birth, pain originating in the uterus radiates to the abdominal wall, lumbosacral area of the back, iliac crests, gluteal area, and down the thighs

Answer 16

referred pain

Question 17

point beyond which pain is perceived

Answer 17

pain threshold

Question 18

level of pain a laboring woman is willing to endure

Answer 18

pain threshold

Question 19

theory of pain based on the principle that certain nerve cell groupings within the spinal cord, brainstem, and cerebral cortex have the ability to modulate the pain impulses through a blocking mechanism
- according to this theory, pain sensations travel along sensory nerve pathways to the brain, but only a limited number of sensations or messages can travel through these nerve pathways at one time

Answer 19

Gate control

Question 20

endogenous opioids secreted by the pituitary gland that act on the CNS and PNS to reduce pain

Answer 20

Beta-endorphines

Question 21

paced breathing technique during which the woman breathes at approx. half her normal rate (6-8 breaths/min)

Answer 21

slow-paced breathing

Question 22

paced breathing technique during which the woman breathes at an accelerated rate, which should not exceed 2x her resting RR (32-40)

Answer 22

modified-paced breathing

Question 23

full breath taken at the beginning of each contraction to greet it, and at the end of each contraction blow it away

Answer 23

cleansing breath

Question 24

paced breathing technique that combines breaths and puffs in a ratio (e.g., 3:1 or 4:1) as a means to enhance concentration during the transition phase of the first stage of labor

Answer 24

pattern-paced (pant-blow) breathing

Question 25

rapid, deep breathing that can be an undesirable outcome of the more rapid and more shallow types of paced breathing techniques

Answer 25

hyperventilation

Question 26

hyperventilation can result in

Answer 26

respiratory alkalosis

Question 27

light stroking of the abdomen or other body part in rhythm with breathing during contractions

Answer 27

effleurage

Question 28

steady pressure applied against the laboring woman’s sacrum by the nurse or coach using the fist or heel of the hand or a firm object (e.g., tennis ball)
- it is especially helpful during back labor

Answer 28

counterpressure

Question 29

nonpharmacologic comfort measure that uses the buoyancy of the warm water to provide support for tense muscles, relief from discomfort, and general body relaxation

Answer 29

hydrotherapy

Question 30

nonpharmacologic pain control technique that involves placing two pairs of electrodes on either side of the woman’s thoracic and sacral spine to provide continuous, low-intensity electrical impulses or stimuli that can be increased during a contraction

Answer 30

TENS

Question 31

nonpharmacologic pain control technique that is based on the application of pressure, heat, or cold on specific body points

Answer 31

acupressure

Question 32

nonpharmacologic pain control technique that involves the insertion of fine needles into specific areas of the body to restore the flow of qi (energy) to decrease pain

Answer 32

acupuncture

Question 33

example of a cutaneous stimulation strategy

Answer 33

therapeutic touch

Question 34

form of deep relaxation, similar to daydreaming or meditation
- the person enters a state of focused concentration and the subconscious mind can be more easily accessed

Answer 34

hyponsis

Question 35

use of essential oils distilled from plants, flowers, herbs, and trees to promote health and well-being, enhance relaxation, and restore balance of mind, body, and spirit

Answer 35

aromatherapy

Question 36

injection of small amounts of sterile water using a fine needle into four locations on the lower back to relieve low back pain

Answer 36

intradermal water block