OB Test 4 Chapter 17

Question 1

When to give sedatives

Answer 1

Prolonged latent phase

Question 2

Undesirable side effects of barbiturate

Answer 2

• resp depression

- casino for depression

Question 3

When to avoid barbiturates

Answer 3

If birth is anticipated w/in 12-24 hrs

Question 4

What will happen if a barbiturate is given w/out an analgesic

Answer 4

Pain will magnify

Question 5

Which sedatives are seldom used during labor

Answer 5

Barbiturates

Question 6

Sedative that doesn’t relieve pain

Answer 6

Phenothiazine (Phenergan)

Question 7

What does Phenergan impair

Answer 7

Analgesic efficacy of opioids

Question 8

What to give instead of Phenergan

Answer 8

Metoclopramide (Reglan)

Question 9

A sedative that when given w/ an opioid analgesic seems to enhance pain relief and reduce N/V

Answer 9

Benzos

Question 10

What do benzos do to the mother

Answer 10

Maternal amnesia

Question 11

If a mother has amnesia during labor and she is taking a benzo, what do you do

Answer 11

Stop it

Question 12

What do benzos do to the fetus

Answer 12

Disrupts their thermoregulation

Question 13

A benzo antagonist that can be given to reverse benzo-induced sedation and resp depression

Answer 13

Flumazenil (Romazicon)

Question 14

Encompasses analgesia, amnesia, relaxation, and reflex activity

Answer 14

Anesthesia

Question 15

Alleviation of the sensation of pain

Answer 15

Analgesia

Question 16

Analgesics that can be administered IV, IM, or PCA

Answer 16

Systemic

Question 17

Medications that provide sedation, euphoria, pain relief

Answer 17

Analgesia

Question 18

When are analgesia best used

Answer 18

Active labor

Question 19

Adverse effects of opioids

Answer 19

• resp depression
• sedation
• N/V
• dizziness
• altered mental status
• euphoria
• decreased GI motility
• delayed gastric emptying
• urinary retention

Question 20

If a women is under general anesthesia and has a prolonged gastric emptying time, what is she at risk for

Answer 20

Aspiration

Question 21

Effects of opioids on the fetus

Answer 21

• absent or minimal FHR variability during labor

- resp depression

Question 22

Opioids that stimulate mu and kappa

Answer 22

Agonist

Question 23

Opioids have an amnesic effect. T or F

Answer 23

F

Question 24

What can opioids do to contractions

Answer 24

Inhibit them

Question 25

When to give opioids

Answer 25

When labor is well established

Question 26

Synthetic opioid that causes less resp depression than morphine

Answer 26

Meperidine hydrochloride (Demerol)

Question 27

Adverse effects of Demerol

Answer 27

- tachycardia - sedation - N/V - dizziness - altered mental status - euphoria - decreased GI motility - delayed GI emptying - urinary retention

Question 28

When to not give Demerol

Answer 28

If birth is expected w/in 1-4 hrs

Question 29

Potent short-acting opioid agonist analgesic

Answer 29

Fentanyl citrate (Sublimaze)

Question 30

Sublimaze readily crosses the placenta. T or F

Answer 30

T

Question 31

Compared w/ meperidine, fentanyl provides what

Answer 31

Equivalent analgesia w/ fewer neonatal effects and less maternal sedation and nausea

Question 32

What is a disadvantage of fentanyl

Answer 32

More frequent dosing

Question 33

Adverse effects of fentanyl citrate (Sublimaze)

Answer 33

- sedation - resp depression - N/V

Question 34

What should be available of fentanyl citrate (Sublimaze) causes resp depression

Answer 34

Naloxone

Question 35

Agent that activates or stimulates a receptor to act

Answer 35

Agonist I

Question 36

Agent that blocks a receptor or a medication that is designed to activate a receptor

Answer 36

Antagonist

Question 37

Which receptors do agonist-antagonist work as agonist for

Answer 37

Kappa

Question 38

Agonist-antagonist opioids provide what

Answer 38

Adequate analgesia w/out causing significant resp depression

Question 39

What is the major advantage of opioid agonist-antagonist

Answer 39

Ceiling effect

Question 40

Opioid agonist-antagonist are less likely to cause N/V but greatly cause what

Answer 40

Sedation

Question 41

When to withhold an opioid agonist-antagonist

Answer 41

Opioid dependent mother

Question 42

Relieve anxiety and induce sleep

Answer 42

Sedatives