Ch. 17

• Pain During Labor and Birth:

  • Visceral - Pain from A_ C_ in organs during C_
  • Somatic - I_, S_, B_, and W_ localized?

  any changes, contractions, intense, sharp, burning, well
• Factors Influencing Pain Response:

  • Nonverbal - I_ in H_ , B_ H_
  • C_
  • Gate-Control Theory of Pain - Can I_ P_ S_ with O_ S_
  • C_, S_, E_?

  increase, hr, breathing heavily, culture, interrupt pain signals, other stimuli, comfort, support, environment
• Pain Management Non-Pharmocologic:

  • Relaxation and Breathing
  • S_ breathing
  • E_ L_; _ to _ breaths/min
  • N_ and S_
  • I_ _ _ _, O_ _ _ _
  • Q_ breathing
  • _ to _ breaths/min
  • M_ A_ L_
  • Worry about H_
  • P_ breathing
  • I_ O_ I_ O_ I_ B_ (_:_)?
  • slow, early labor, 6, 8, nice, slow, quick, 32, 40, more active labor, hyperventilation, patterned, in, out, in, out, in, blow, 4, 1
• Non-Pharmocologic Pain Managment:

  • Effleurage - L_ T_
  • Counterpressure - D_ P_ on S_ region
  • Water Therapy
  • Keep water _ to _ degrees
  • Contrandications
  • C_ M_
  • M_ F_
  • I_ and P_
  • V_ B_?
  • light touch, direct pressure, sacral, 96.8, 99.5, continuous monitoring, maternal fever, infection, preterm, vaginal bleeding
• Pharmacologic: Systemic Analgesia

  • O_
  • Don't give if O_ D_ M_ with A_ only
  • Don't P_ M_ during C_
  • Don't give if baby is going to be D_ within _ to _ hrs
  • Can give when _ to _ cm?

  opioids, opioid dependent mother, antagonists, push med, contractions, delivered 1, 4, 1, 3
• Pharmacologic: Nerve Block

  • S_
  • Used for C_
  • Post-dural P_ H_
  • L_ of S_ P_
  • E_ B_ patch?
  • spinal, c sections, puncture headaches, leakage, spinal fluid, epidural blood patch
• Contraindications to subarchnoid and epidural blocks

  • H_, C_, I_,
  • I_ I_ P
  • A_
  • C_ C_
  • P_ count < _?

  hypotension, coagulopathy, infection, increased intracranial pressure, allergies, cardiac conditions, platlet, 150
• Pharmacologic:

  • Nitrous Oxide
  • I_ L_ during F_ and S_ stages of labor
  • General Anethesia
  • Only if S_ C_ or C_ for E_
  • C_ O_ A_
  • Be delivered as S_ A_ P_?
  • inhaled low, first, second, stat section, contraindication, epidural, clear oral antiacid, soon as possible
• Care Management for Nonpharmacologic Interventions:

  • P_ A_ during labor and birth
  • B_ Techniques
  • A_ women how she F_ to evaluate specific P_ T_
  • During
  • Take B_ q F_ M_
  • After
  • A_, R_, N_ D_ in B_
  • Give I_ B_ or L_ or N_ when _ over something
  • If D_ maybe more B_ or V_ E_
  • Less than _ is concerning?
  • pain assessment, breathing, ask, feels, pain technique, bp, few minutes, assess, reposition, no drop, bp, iv bolus, lr, ns, 125, drops, bolus, vasopressor ephedrine, 20
• Care Managment for Pain

  • E_ B_ for E_
  • S_ cath q _ hrs
  • F_ for G_ A_?

  empty bladder, epidural, straight, 2, foley, gen anesthesia