Show:
Regional
Systemic
Non-Pharmacological
Pain
Physiologic / Psychological
100
What is the biggest advantage of regional pain management ( epidural, spinal, intrathecal, infiltration )?
Good pain control but mom can still participate in the delivery
100
What is the most common drug class used for systemic pain management for labor?
What is opiods Demerol, Sublimaze, Stadol, and Nubain
100
Name 3 advantages of non-pharmacologic pain management during labor?
no side effects won't slow labor no allergy risks Limitation? May not receive desired level of pain control
100
Is pain objective or subjective?
Subjective Each patients response to the pain of labor will be unique
100
Name 3 PHYSIOLOGICAL factors that influence the PERCEPTION of labor pain
intensity of labor cervical readiness fetal position pelvis size and shape fatigue and hunger
200
Where is an epidural placed and what are the contraindications?
Epidural space between the dura and the spinal cord at the level of the 3rd and 4th vertebrae (below the spinal cord) Contra: low platlets, hypovolemia, spinal abnormalities, dire fetal condition
200
What is the Demerol warning?
Long lasting metabolite with a half-life of 15-23 hrs in the newborn
200
It is thought non-pharmacological pain methods provide relief through what pain control theory?
What is the Gate-Control Theory
200
Name 2 types of pain
visceral - slow, deep, poorly localized somatic - quick, sharp, localized 1st stage visceral 2nd stage somatic
200
Name 3 PSYCHOLOGICAL factors influencing PERCEPTION of labor pain
Culture anxiety and fear previous experiences preparation support system
300
What are the adverse effects of an epidural /spinal ?
Maternal hypotension, fetal bradycardia Foley, resp. depression, itching, N/V May lose bearing down reflex
300
What is the Stadol / Nubain warning?
Do not give to opioid addicted moms because it will cause withdrawal in mom and baby
300
Name 3 non-pharmacologic pain relief techniques
Childbirth preparation relaxation cutaneous stimulation effleurage, counter pressure, thermal, hydrotherapy mental stimulation imagery, focal point breathing techniques
300
How is labor pain different from other pain?
normal process, expected, self-limiting, intermittent, reward
300
Name 3 non-verbal cues of pain
Increase BP, pulse, hyperventilation crying, moaning, writhing, withdrawal
400
What is the difference between and epidural and a spinal?
Same prep Into the subarachnoid space in a single dose. 3rd, 4th, or 5th lumbar interspace loss of sensory and motor function below the level of the block Quicker than epidural Worse maternal hypotension
400
Narcotic antagonist
What is Narcan Do not give to infants of opioid addicted moms
400
Video Bonus!!!!!
What is Bradley https://www.youtube.com/watch?v=cuxKvrKpeOU
400
Name 2 adverse effects of excessive pain with labor
Decrease blood flow to and from placenta Decrease effectiveness of contractions (slows labor)
400
Other than a number on a pain scale, what assessments do we need to make regarding pain?
Client's beliefs and expectations Description of pain
500
Name 2 kind of infiltration for regional pain management for labor
Pudendal block - long trumpet needle into the pudendal nerves at the ischial spines bilaterally Local - epis repair
500
Two types of systemic drugs used in labor other than opiods
Sedatives - Early latent phase only to help with anxiety / sleep Adjunctive - Phenergan and Vistaril for anxiety and nausea Vistaril warning????
500
Video Bonus!!!!
Lamaze breathing https://www.youtube.com/watch?v=pdUc9rjhCzU&list=PLqT_VB-JB60Ol1gTAZ_dPkIMnjQeIXb2O
500
Name 2 psychological effects of excessive pain with labor
Decrease pleasure in event, increase fear and anxiety, interferes with bonding