Conference One - Pain (Exam 2) 1 Flashcards Preview

Semester Three - Half Two - Nursing 212 > Conference One - Pain (Exam 2) 1 > Flashcards

Flashcards in Conference One - Pain (Exam 2) 1 Deck (8)
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1

Gate Control Theory

Perception of pain is modulated by interaction between different neurons

2

Small-diameter sensory nerve fibers

Carry pain sensations to the brain

3

Large-diameter sensory nerve fibers

Stimulation of these nerve fibers overrides conduction of impulses interpreted as painful (closes the gate, cancels out small-diameter sensory nerve fibers)

 

4

Examples of large-diameter sensory nerve fiber stimulation

  1. Touch relaxation
  2. Sacral pressure
  3. Massage
  4. Hydrotherapy
  5. Birthing Ball

5

Non-Pharmacological management of pain techniques

  1. Education/Prepartion for labor/pain/birth
  2. Relaxation/Massage
  3. Paced/Patterned Breathing
  4. Focal Point/Imagery
  5. Hydrotherapy
  6. Position Changes
  7. Ambulation
  8. Birthing Ball

6

Nubain (Nalbuphine)

Decreases perception of pain

  • 10mg IV q 3-4 hours PRN
  • Slow push, direct IV
  • Maternal drowsing between contractions
  • Readily crosses placental border
  • Giving this medication during the latent phase may slow labor
  • Administer with start of contraction to decrease transfer to placenta
  • Potential indication for neonatal Narcan (respiratory depression)

7

Epidural Anesthesia

  • Sensory block in lower extremities
  • Motor block to varying degrees
  • Invasive procedure, not without risk
  • Impacts feasibility of many non-pharmacologic pain management options

8

Nursing Considerations for Epidural Anesthesia

  • Maternal Hypotension
    • Impaired uteroplacental perfustion leads to FHR abnormalities r/t hypoxia
      • Continuous EFM
      • Compensatory IV fluid bolus in advance of anesthesia
  • Bladder Distention
    • Straight Catheter, sometimes a foley
  • Prolonged Second Stage
    • Delayed ability to integrate muscle memory
    • Laboring down/passive descent

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