Pain- EXAM 1

Question 1

First stage of pain during labor

Answer 1

Dilation of cervix= primary source of pain
Stretching of lower uterine segment
Pressure on adjacent structures

Question 2

Causes of Second stage labor pains

Answer 2

Hypoxia of contracting uterine muscle cells
Distention of vagina and perineum
Pressure on adjacent structures

Question 3

Third stage of pain during labor

Answer 3

Uterine contractions
Cervical dilation

Question 4

Nursing considerations before administering medications

Answer 4

Assess for history of any medication reactions or allergies
Provide info about the medication
Document assessment data: Maternal vital signs, FHR, pain level

Question 5

What are opioid analgesics used for

Answer 5

early labor
Provide analgesic effect
Induce sedation

Question 6

What are sedatives used for

Answer 6

To promote rest

Question 7

Considerations following medication admin

Answer 7

Record drug name, dose, route, and site
Record womens blood pressure and pulse
Assess and document data: pain level, effectiveness, adverse effects if any
Safety precautions

Question 8

What is Regional anesthesia & examples of it

Answer 8

Provides pain relief throughout labor
Instituted once labor is well establish, 4-5 cm dilated
Ex: epidural, Spinal and Combined epidural-spinal

Question 9

Level of anesthesia for vaginal birth

Answer 9

pelvis down

Question 10

Level of anesthesia for c-section

Answer 10

under breast down

Question 11

What to do when prepping a patient for epidural

Answer 11

Confirm availability of obstetrician
Encourage women to void
Assess data: Maternal pain level, BP, respirations and fetal heart rate
Continuous electronic fetal monitoring

Question 12

Where do you place an epidural & SE

Answer 12

Needle goes into epidural space
Patient lies on sidde
catheter is inserted through intervertebral space between L2 and L3
SE: Pruitius, Nauseated vommiting, urinary retention

Question 13

Advantages of epidural

Answer 13

Produces good pain relief
Women is fully awake during labor and birth
Allows different blocking for each stage of labor
Dose can be adjusted

Question 14

Disadvantages of epidural

Answer 14

Hypotension
Loss of bladder sensation
Prolonged labor
Low back pain

Question 15

Contraindications of epidurals

Answer 15

Patents may refuse
Infection at needle puncture site
Increased intracranial pressure
Allergy to
Hypovolemic shock

Question 16

Complications of epidural

Answer 16

postpartum low back pain
nerve injury
infection
hematoma
hypotension
respiratory depression
inadequate pain relief

N/V
Urinary retetnion
Pruitus

Question 17

Nursing interventions during epidural

Answer 17

Assess maternal vital signs until block wears off
Promote maternal side lying position or what’s comfortable
Frequent repositioning
Assess sensorimotor ability every 30 min
Assess bladder distention
Protect lower extremeties from injury

Question 18

Spinal anesthesia

Answer 18

Injected into smaller needle directly into cerebrospinal fluid that surrounds the spinal cord
Nubms the whole body below and sometimes above the injection site
Common ones used are Lidocaine, Bupivacaine, Tetracaine and Ropivacaine

Question 19

Lidocaine

Answer 19

Used as spinal anesthesia, Lasts 1-1.5 hours
Monitor BP & HR

Question 20

Bupivacaine

Answer 20

Spinal anesthesia that can be used
Lasts 90-150 minutes

Question 21

Tetracaine

Answer 21

Spinal anesthesia used
Long lasting one, 10+ hours

Question 22

Ropivacaine

Answer 22

Spinal anesthesia used
Long lasting one, 10+ hours

Question 23

Nursing interventions of spinal anesthesia

Answer 23

Position women supine with left uterine displacement
Monitor maternal blood pressure and pulse

Question 24

Recovery from spinal

Answer 24

Cautious transfers from birthing bed
Bedrest for 6-12 hours following block
Restoration of bladder control may take 8-12 hours

Question 25

What is the biggest side affect of pain med

Answer 25

Hypotension
risk is minimized by admin of crystalloid fluid bolus
If occurs, increase IV flow rate, and administer oxygen
Administer ephedrine if indicated

Question 26

Nonpharmacologic methods

Answer 26

Control pain during labor
natural childbirth, hypnosis, biofeedback, acupuncture,TENS, psychosocial support

Question 27

Describe cancer pain

Answer 27

Experienced by 55% of patients undergoing anti-cancer treatment and by 66% who have advanced, metastatic or terminal disease

Question 28

Causes of cancer pain

Answer 28

Direct tumor involvement
Side effects or toxic effects of cancer therapies

Question 29

Acute pain

Answer 29

well-defined pattern of onset
Exhibits common signs and symptoms

Question 30

Chronic pain

Answer 30

Lasts more than 6 months
Often results in personality changes, alterations in functional abilities and lifestyle disruptions

Question 31

Most common medical disroder

Answer 31

Acute lower back pain

Question 32

Mild pain
Number range and med level

Answer 32

1-3 on pain scale
Nonopiod medication administered for it
NSAID or ASPRIN

Question 33

Moderate pain
Number scale and meds used

Answer 33

4-6 on pain scale
Weak opioids given
CODINE, TRAMADOL OR LOW DOSE OF MORPHINE

Question 34

Severe pain
Number range & meds used

Answer 34

7-10 on pain scale
Strong opioids given
MORPHINE, FENTANYL, OXY, HYDROMORPHINE & BUPROMORPHINE