Pain Management in Pregnancy
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Questions and Answers

What are common behavioral signs indicating pain?

  • Calmness and relaxation
  • Increased appetite and activity
  • Withdrawal and lack of communication
  • Increased BP, tachycardia, hyperventilation (correct)

    • Which of the following is NOT a non-pharmacological method of pain relief?

  • Sedatives (correct)
  • Aromatherapy
  • Back rub/massage
  • Lamaze

    • What is a common side effect of administering opioids during labor?

  • Enhanced maternal energy levels
  • Improved muscle strength
  • Decreased fetal heart rate (FHR) (correct)
  • Increased alertness in the mother

    • When should an epidural block be administered during labor?

    <p>At least 4 cm dilated (A)</p> Signup and view all the answers

    Which medication is typically used for nausea and anxiety control during labor?

    <p>Metoclopramide (C)</p> Signup and view all the answers

    What is a necessary nursing action if hypotension occurs after spinal anesthesia?

    <p>Position the patient laterally (C)</p> Signup and view all the answers

    What is a potential adverse effect of using opioids during labor?

    <p>Neonate respiratory distress (B)</p> Signup and view all the answers

    Which statement regarding the use of sedatives during labor is accurate?

    <p>They are not typically administered because of potential risks. (D)</p> Signup and view all the answers

    Flashcards

    Non-pharmacological pain relief methods

    Techniques for pain relief that do not involve medication, such as Lamaze, aromatherapy, and massage.

    Opioid pain relief (early labor)

    Medications used to manage pain during labor, but may cause respiratory depression in the newborn if administered near delivery time.

    Epidural block indication

    An epidural block is a pain relief technique often used during labor. It is a type of regional anesthesia that numbs the lower half of the body and can only be performed IF the cervix is dilated 4+ cm.

    Epidural block adverse effects

    Potential side effects of an epidural block include hypotension (low blood pressure), fetal bradycardia (slow heart rate), and potential urinary dysfunction.

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    Nursing actions for hypotension (post-epidural)

    Nursing interventions for hypotension following an epidural block, such as bolus IV fluids, positioning, and oxygen.

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    Spinal anesthesia (block)

    A type of regional anesthesia commonly used frequently for C-sections that numbs the lower body. It can result in adverse effects such as hypotension.

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    Spinal block adverse effects

    Potential side effects of a spinal block include hypotension, fetal bradycardia and maternal bladder and uterine atony.

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    Nursing actions for spinal anesthesia hypotension

    Nursing interventions for hypotension after spinal anesthesia, including frequent vital checks, fluids, positioning, and oxygen.

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    Study Notes

    Pain Management

    • Indications of pain:
      • Increased blood pressure, tachycardia, hyperventilation
      • Nausea and vomiting (N/V)
    • Non-pharmacological pain relief:
      • Lamaze techniques
      • Breathing exercises (e.g., paper bag)
      • Aromatherapy, music, dim lighting
      • Back massage
      • Sacral counterpressure (applying pressure to sacral area)
    • Pharmacological pain relief:
      • Sedatives (not typically given during labour unless for complications)
      • Neonates: avoid sedatives for 12-24 hours before birth
      • Potential risks of sedation: increased risk of nausea and vomiting, risk for aspiration, decreased heart rate, and decreased fetal heart rate
      • Risks of opioids: resp-depression
      • Analgesics: butorphanol/nalbuphine (pain relief without respiratory depression)
      • Anti-emetics necessary if opioids given. Naloxone should be available if opioid use occurs.
      • Metoclopramide for nausea & anxiety control
      • Epidural block: must be at least 4cm dilated

    Urinary Retention

    • Unable to bear down: -Nursing interventions: Bolus IV fluids to treat hypotension. Side-lying position with back curved. -Orthostatic hypotension: IV vasopressors (e.g., epinephrine), position laterally, increase IV fluid rate, and initiate supplemental oxygen (O2) -Spinal anesthesia (e.g., for C-section)
      • Potential complications: fetal bradycardia, hypotension
    • Nursing actions: -Vital signs (q10 minutes) -IV fluid bolus -Lateral positioning -Increase IV fluids (if needed)
      • Supplemental oxygen (O2)
      • Assess contractions and FHR (continuous monitoring)
      • HA due to CSF leakage: bed rest, dark room, oral analgesics, caffeine, fluids.

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