Promotion of Comfort Flashcards

1
Q

what is the objective during the first stage of labor?

A

to know the patients pain goal and birth plan

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2
Q

ambulation (walking)
position changes
quiet envt
aromatherapy
acupressure

A

Non-pharmacologic measures to decrease pain

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3
Q

an upright position (walking, sitting, kneeling and squatting) promote what?

A

promotes descent of fetus

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4
Q

being on your hands and knees helps the fetus do what?

A

Helps the fetus rotate (LOP or ROP)

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5
Q

non-pharmacologic ways to assure comfort during the first stage of labor

A

birthing ball
peanut ball
bathtub
breathing techniques
heat or cold
massage
meditation
etc.

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6
Q

what is the key thing to remember about pharmacologic medications during labor?

A

Important to know that almost all pharmacologic medications gross the placenta and have some effect on fetus

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7
Q

the goal of pharmacologic pain management is

A

relax and relieve discomfort

not necessarily be “pain free”

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8
Q

common side effects of medication?

A

decreased oxygenation and decreased blood pressure

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9
Q

what is the National safety goals in regards to medication in labor?

A

Never give medication to
pregnant woman unless benefit outweighs risk

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10
Q

Common opioids used for childbirth

A
  • Butorphanol tartate (Stadol)
  • Nalbuphine (Nubain)
  • Fentanyl (Sublimaze)
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11
Q

if you use an opioid for pain relief during labor what MUST be available, if needed.

A

Narcan

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12
Q

what is the time frame to give an opioid to a laboring mom

A

want at least 3 hours prior to delivery.

due to the metabolism in the fetus

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13
Q

what can opioids cause for mom and baby?

A

Can cause maternal respiratory depression and fetal CNS depression

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14
Q

what must be throughly checked (for fetus) if mom received an opioid during labor?

A

Respiratory status should be monitored in newborn

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15
Q

what are 2 common regional anesthesias

A

Bupivacaine
Chloroprocaine

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16
Q

where is an anesthetic agent placed?

A

epidural space
L4-L5
L3-L4
L2-L3

17
Q

what is the goal for an epidural?

A

for the laboring mom to still be able to feel a contraction coming on so she is aware when to push for delivery BUT relieve the discomfort and pain of the contractions

18
Q

in the laboring mom what is the most common side effect of an epidural?

A

hypotension

19
Q

These are side effects of what pain management medicine?

Hypotension (blocking effect on sympathetic nerves) risk is reduced if well hydrated

◦ Intense pruritus; Spinal headaches are rare

◦ May prolong 2nd stage of labor (Adm. of oxytocin will shorten labor)

◦ Loss of sensation of bladder filling

◦ Effects on fetus

A

epidural

20
Q

When and only when do we use Spinal anesthesia?

A

Cesarian Section delivery

21
Q

when do we use General anesthesia as a pain blocker?

A

Cesarian Section delivery EMERGENCY