Subjective
Individual
Each client's response is unique
What is Pain
100
Analgesic and Anesthesia
What are the two types of pharmacologic pain management in labor
100
The concept that the sensory nerve pathways that pain sensations use to travel to the brain will allow only a limited number of sensations to travel at any given time
What is Gate Control Theory?
100
The most common form of pain relief during labor in the US
Epidural
100
Neonatal depression may occur if given
What is within one hour of delivery
200
Rate of dilatation
Strength of uterine contractions
Size and position of fetus
Culture
Support system
Childbirth preparation and past experiences
What are factors that influence pain
200
Stadol
Nubain
Fentanyl
Demerol
What analgesic medications used in labor
200
Aromatherapy
Breathing techniques
Imagery
Music
Focal points
Subdued lighting
What are Sensory stimulation strategies
200
IV fluid bolus and Platelet count
What are things that have to be done before epidural administration.
200
This client may have a lessened effect from pain medication and require higher doses
Who is a women with a history of drug abuse
300
Anxiety
Fear
What are things that can exacerbate pain
300
Regional Blocks (pudendal, epidural, spinal, paracervical)
General
What are the types of anesthesia used in labor
300
Back rubs
Massage
Effleurage
Sacral counter pressure
Heat or Cold Therapy
Hydrotherapy
What are Cutaneous strategies
300
Monitor vital signs, mobility, LOC, perception of pain, and fetal status
What are nursing responsibilities after an epidural / spinal are administered.
300
What type of patient should NOT receive Stadol or Nubain (opioid agonist-antagonist)
What is a drug dependent patient - due to the risk of sudden withdrawal
400
Increasing heart rate
tachycardia
hyperventilation
withdrawal
inability to follow instructions
What are indications of pain
400
Narcan
What is a medication that must be readily available when using analgesics in labor
400
Semi-squatting
squatting
kneeling
supine with wedge
What are maternal position changes to promote relaxation and pain relief
400
Level of anesthesia (umbilicus vs nipples) and space injected into
What is the difference between an epidural and a spinal
400
Opioids cross the placenta and can cause
What is respiratory depression
500
The first consideration of the nurse when planning pain management measures
What is the safety of the mother and fetus
500
A new interest in labor analgesia is
What is Nitrous Oxide
500
Emotional support
Physical support
Informational support
Advocacy
Support of the partner and family
What are Non pharmacological Strategies for nurses and comfort measures in labor
500
Maternal hypotension
Fetal bradycardia
Inability to feel the urge to void
Loss of the bearing down reflex
Potential headache from leakage of CSF at puncture site
Higher incidence of maternal bladder and uterine atony