Podcast
Questions and Answers
What is the primary benefit of using nitrous oxide during labor?
What is the primary benefit of using nitrous oxide during labor?
- It induces labor more quickly.
- It prevents any side effects for the mother.
- It provides analgesic and anxiolytic effects. (correct)
- It ensures a painless delivery.
How is client satisfaction evaluated when using nitrous oxide compared to epidurals?
How is client satisfaction evaluated when using nitrous oxide compared to epidurals?
- Satisfaction with N2O and epidurals was rated equally. (correct)
- Only clients who had previous experiences rated their satisfaction.
- Participants rated satisfaction with N2O significantly lower than with epidurals.
- Client satisfaction was linked to hospital facilities available.
For which circumstances might nitrous oxide be particularly beneficial during labor?
For which circumstances might nitrous oxide be particularly beneficial during labor?
- When the mother is more than 5 cm dilated. (correct)
- When an epidural is readily available.
- When the mother has a high pain tolerance.
- When the mother intends to give birth at home.
What is a key advantage of using nitrous oxide in laboring clients in the community?
What is a key advantage of using nitrous oxide in laboring clients in the community?
What factors are linked to client satisfaction regarding the administration of N2O?
What factors are linked to client satisfaction regarding the administration of N2O?
What is one of the main analgesic mechanisms of action for N20?
What is one of the main analgesic mechanisms of action for N20?
Which of the following effects does N20 have that is similar to benzodiazepines?
Which of the following effects does N20 have that is similar to benzodiazepines?
What is a rapid onset time for N20 administration?
What is a rapid onset time for N20 administration?
Which of the following is considered a benefit of using N20?
Which of the following is considered a benefit of using N20?
How does N20 affect the fetal heart rate?
How does N20 affect the fetal heart rate?
Which adverse effect is NOT commonly associated with N20 usage?
Which adverse effect is NOT commonly associated with N20 usage?
What hormonal response does N20 help reduce?
What hormonal response does N20 help reduce?
During which condition should the use of N20 be evaluated?
During which condition should the use of N20 be evaluated?
What is a characteristic of the offset time when N20 is discontinued?
What is a characteristic of the offset time when N20 is discontinued?
What effect does N20 have on uterine activity?
What effect does N20 have on uterine activity?
What is a primary component of active management during the third stage of labor?
What is a primary component of active management during the third stage of labor?
What does recent evidence suggest about the effectiveness of optimal physiologic management compared to active management?
What does recent evidence suggest about the effectiveness of optimal physiologic management compared to active management?
Which of the following has been shown to probably reduce blood loss of 500 mL or more in comparisons to expectant management?
Which of the following has been shown to probably reduce blood loss of 500 mL or more in comparisons to expectant management?
What complication may be increased in low-risk participants who undergo active management during the third stage of labor?
What complication may be increased in low-risk participants who undergo active management during the third stage of labor?
Which of the following is NOT commonly recommended as part of an active management package?
Which of the following is NOT commonly recommended as part of an active management package?
What cultural consideration is emphasized when providing care to Indigenous clients during labor?
What cultural consideration is emphasized when providing care to Indigenous clients during labor?
Which procedure is becoming increasingly outdated in the active management of third-stage labor?
Which procedure is becoming increasingly outdated in the active management of third-stage labor?
What is a limitation noted in the studies regarding active management packages?
What is a limitation noted in the studies regarding active management packages?
What is one of the primary benefits of monitoring and treating iron deficiency anemia after postpartum hemorrhage (PPH)?
What is one of the primary benefits of monitoring and treating iron deficiency anemia after postpartum hemorrhage (PPH)?
Which of the following statements regarding oral and IV iron therapy post-PPH is correct?
Which of the following statements regarding oral and IV iron therapy post-PPH is correct?
What aspect should midwives consider when recommending iron supplementation for clients post-PPH?
What aspect should midwives consider when recommending iron supplementation for clients post-PPH?
What does the recommendation for clients who experience PPH recognize in its approach to treatment?
What does the recommendation for clients who experience PPH recognize in its approach to treatment?
Which factor may influence the effectiveness of communication during and after PPH?
Which factor may influence the effectiveness of communication during and after PPH?
What is the primary focus of the good practice statement regarding racism in healthcare for birthing communities?
What is the primary focus of the good practice statement regarding racism in healthcare for birthing communities?
Which approach to third-stage management involves a hands-off technique?
Which approach to third-stage management involves a hands-off technique?
During informed choice discussions about management options, midwives should consider which of the following aspects?
During informed choice discussions about management options, midwives should consider which of the following aspects?
Physiologic management of the third stage focuses on promoting which of the following?
Physiologic management of the third stage focuses on promoting which of the following?
What critical mental process should midwives engage in to improve care for racialized clients?
What critical mental process should midwives engage in to improve care for racialized clients?
What is a key characteristic of expectant management during the third stage of labor?
What is a key characteristic of expectant management during the third stage of labor?
Which of the following does NOT contribute to inequitable rates of postpartum hemorrhage according to the good practice statement?
Which of the following does NOT contribute to inequitable rates of postpartum hemorrhage according to the good practice statement?
In the context of managing postpartum hemorrhage (PPH), midwives must identify risk factors in which manner?
In the context of managing postpartum hemorrhage (PPH), midwives must identify risk factors in which manner?
Which concept underlies the need for racially concordant client care among midwives?
Which concept underlies the need for racially concordant client care among midwives?
What is the significance of flexible timing for meetings with clients?
What is the significance of flexible timing for meetings with clients?
What is an important step to ensure after the discharge of clients?
What is an important step to ensure after the discharge of clients?
Why is debriefing important for clients post-discharge?
Why is debriefing important for clients post-discharge?
What is a key component of postnatal support offered to clients?
What is a key component of postnatal support offered to clients?
What is a potential outcome of postpartum hemorrhage that healthcare teams should be aware of?
What is a potential outcome of postpartum hemorrhage that healthcare teams should be aware of?
Which role does the client's primary care team play post-discharge?
Which role does the client's primary care team play post-discharge?
What may be a necessary follow-up from care teams after postpartum hemorrhage?
What may be a necessary follow-up from care teams after postpartum hemorrhage?
What can be advocated for post-discharge to assist clients?
What can be advocated for post-discharge to assist clients?
Postpartum hemorrhage outcomes should consider which of the following?
Postpartum hemorrhage outcomes should consider which of the following?
What common misconception might clients have regarding postpartum support?
What common misconception might clients have regarding postpartum support?
How does active management during birth compare to physiologic management in terms of blood loss risk?
How does active management during birth compare to physiologic management in terms of blood loss risk?
What has become the standard of care for delayed cord clamping in Ontario?
What has become the standard of care for delayed cord clamping in Ontario?
What role does skin-to-skin contact play in the management of the third stage of labor?
What role does skin-to-skin contact play in the management of the third stage of labor?
Which of the following statements is TRUE regarding the role of midwives in managing third-stage options with clients?
Which of the following statements is TRUE regarding the role of midwives in managing third-stage options with clients?
What is a strong recommendation for midwives regardless of third-stage management chosen?
What is a strong recommendation for midwives regardless of third-stage management chosen?
What should midwives expect to monitor for during the third stage of labor?
What should midwives expect to monitor for during the third stage of labor?
What is necessary for midwives who support the use of herbal and homeopathic remedies?
What is necessary for midwives who support the use of herbal and homeopathic remedies?
What elements should midwives include in their discussion with clients about third-stage management?
What elements should midwives include in their discussion with clients about third-stage management?
How does delayed cord clamping benefit the newborn?
How does delayed cord clamping benefit the newborn?
What should be the focus of midwives regarding the presence of risk factors in clients?
What should be the focus of midwives regarding the presence of risk factors in clients?
Which of the following factors is NOT included in the active management of the third stage of labor?
Which of the following factors is NOT included in the active management of the third stage of labor?
What is a potential disadvantage of active management for low-risk participants during the third stage of labor?
What is a potential disadvantage of active management for low-risk participants during the third stage of labor?
In which scenario might optimal physiologic management by midwives be more effective than active management?
In which scenario might optimal physiologic management by midwives be more effective than active management?
Which component of an active management package is becoming increasingly outdated?
Which component of an active management package is becoming increasingly outdated?
What is an essential cultural consideration midwives must honor when managing care for Indigenous clients?
What is an essential cultural consideration midwives must honor when managing care for Indigenous clients?
What does recent evidence suggest regarding the use of uterotonics in active management?
What does recent evidence suggest regarding the use of uterotonics in active management?
Which of the following aspects of postpartum management should midwives NOT overlook?
Which of the following aspects of postpartum management should midwives NOT overlook?
Which procedure used in historical active management is currently not recommended?
Which procedure used in historical active management is currently not recommended?
What is a significant benefit of monitoring and treating iron deficiency anemia after postpartum hemorrhage (PPH)?
What is a significant benefit of monitoring and treating iron deficiency anemia after postpartum hemorrhage (PPH)?
Which option correctly reflects a concern when comparing oral iron therapy to intravenous (IV) iron therapy for clients post-PPH?
Which option correctly reflects a concern when comparing oral iron therapy to intravenous (IV) iron therapy for clients post-PPH?
What should midwives consider when recommending iron supplementation for clients experiencing iron deficiency anemia after PPH?
What should midwives consider when recommending iron supplementation for clients experiencing iron deficiency anemia after PPH?
Which of the following is recognized as a strong recommendation for clients who have experienced PPH and signs of iron deficiency anemia?
Which of the following is recognized as a strong recommendation for clients who have experienced PPH and signs of iron deficiency anemia?
What is one of the best practices for communication during and following postpartum hemorrhage (PPH) to mitigate emotional impacts?
What is one of the best practices for communication during and following postpartum hemorrhage (PPH) to mitigate emotional impacts?
What is a key aspect of ongoing risk factor identification for postpartum hemorrhage (PPH)?
What is a key aspect of ongoing risk factor identification for postpartum hemorrhage (PPH)?
What is the primary focus of expectant management during the third stage of labor?
What is the primary focus of expectant management during the third stage of labor?
Which method promotes hormonal stimulation during the third stage of labor?
Which method promotes hormonal stimulation during the third stage of labor?
What implicit bias should midwives be aware of to better support diverse birthing communities?
What implicit bias should midwives be aware of to better support diverse birthing communities?
How should midwives approach informed choice discussions with clients about third stage management?
How should midwives approach informed choice discussions with clients about third stage management?
What is a significant outcome of addressing implicit biases in midwifery care?
What is a significant outcome of addressing implicit biases in midwifery care?
What does physiologic management of the third stage of labor specifically involve?
What does physiologic management of the third stage of labor specifically involve?
Why is acknowledging racism important for midwives working with birthing communities?
Why is acknowledging racism important for midwives working with birthing communities?
In which manner should midwives identify risk factors for postpartum hemorrhage?
In which manner should midwives identify risk factors for postpartum hemorrhage?
What kind of care does racially concordant client care aim to support?
What kind of care does racially concordant client care aim to support?
What increased risk is associated with active management during birth settings?
What increased risk is associated with active management during birth settings?
What is a primary component that midwives should offer regardless of third-stage management approach?
What is a primary component that midwives should offer regardless of third-stage management approach?
Which factor should be considered during informed choice discussions about third-stage management?
Which factor should be considered during informed choice discussions about third-stage management?
What is a core benefit of chest/breastfeeding immediately after birth?
What is a core benefit of chest/breastfeeding immediately after birth?
What knowledge should midwives have when supporting the use of herbal remedies?
What knowledge should midwives have when supporting the use of herbal remedies?
Which practice is recognized as a good practice statement for midwives?
Which practice is recognized as a good practice statement for midwives?
What does physiologic management emphasize in the third stage of labor?
What does physiologic management emphasize in the third stage of labor?
What consideration is important for midwives when discussing cultural practices with clients?
What consideration is important for midwives when discussing cultural practices with clients?
What is one key element midwives should monitor during the third stage of labor?
What is one key element midwives should monitor during the third stage of labor?
Which management option is often misunderstood by clients regarding postpartum care?
Which management option is often misunderstood by clients regarding postpartum care?
What is an important consideration when scheduling meetings with clients?
What is an important consideration when scheduling meetings with clients?
Which follow-up action is essential after clients are discharged?
Which follow-up action is essential after clients are discharged?
Why is debriefing and checking in with clients important as they recover?
Why is debriefing and checking in with clients important as they recover?
What type of support should be advocated for if available after discharge?
What type of support should be advocated for if available after discharge?
What is a recommended action for addressing long-term mental health impacts in clients?
What is a recommended action for addressing long-term mental health impacts in clients?
Which statement accurately reflects the importance of follow-up communication?
Which statement accurately reflects the importance of follow-up communication?
What might be a misconception clients have regarding postpartum support?
What might be a misconception clients have regarding postpartum support?
Which approach is essential when advocating for post-discharge care?
Which approach is essential when advocating for post-discharge care?
What is a key benefit of offering counseling after postpartum discharge?
What is a key benefit of offering counseling after postpartum discharge?
What is the role of the client’s primary care team post-discharge?
What is the role of the client’s primary care team post-discharge?
Flashcards
Nitrous Oxide
Nitrous Oxide
A colorless gas used for pain relief during childbirth, with fast action and safety.
Intrapartum Pain Relief
Intrapartum Pain Relief
Pain relief during childbirth.
N2O Benefit
N2O Benefit
Provides pain relief, especially when dilation is above 5cm, while maintaining client control and mobility, and reduces anxiety.
Client Satisfaction
Client Satisfaction
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Analgesic and Anxiolytic Effects
Analgesic and Anxiolytic Effects
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N2O Analgesic Effect
N2O Analgesic Effect
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N2O Anxiolytic Effect
N2O Anxiolytic Effect
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N2O Onset/Offset
N2O Onset/Offset
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N2O Fetal Effects
N2O Fetal Effects
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N2O Mobility Preservation
N2O Mobility Preservation
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Respiratory Depression N2O
Respiratory Depression N2O
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N2O Adverse Effects (incl.)
N2O Adverse Effects (incl.)
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N2O Uterine Activity
N2O Uterine Activity
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N2O Cost
N2O Cost
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N2O Non-invasive
N2O Non-invasive
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Active Management of Third Stage
Active Management of Third Stage
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Expectant Management of Third Stage
Expectant Management of Third Stage
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Physiologic Management of Third Stage
Physiologic Management of Third Stage
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Third Stage Interventions
Third Stage Interventions
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Fundal Massage
Fundal Massage
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Controlled Cord Traction (CCT)
Controlled Cord Traction (CCT)
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Uterotonic Medications
Uterotonic Medications
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Cultural Safety in Third Stage
Cultural Safety in Third Stage
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Racial Concordant Care
Racial Concordant Care
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Equity-Denied Birthing Communities
Equity-Denied Birthing Communities
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Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage (PPH)
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Risk Tolerance
Risk Tolerance
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Informed Choice Discussions
Informed Choice Discussions
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Continuity of Care
Continuity of Care
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Emerging Risk Factors
Emerging Risk Factors
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Uterotonic Agent
Uterotonic Agent
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What are the two options for treating iron deficiency anemia after PPH?
What are the two options for treating iron deficiency anemia after PPH?
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PPH and Iron Deficiency Anemia
PPH and Iron Deficiency Anemia
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Iron Supplementation: IV vs Oral
Iron Supplementation: IV vs Oral
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Iron Deficiency Anemia: Postpartum Care
Iron Deficiency Anemia: Postpartum Care
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Iron Deficiency Anemia: Client Context
Iron Deficiency Anemia: Client Context
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Delayed Cord Clamping
Delayed Cord Clamping
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Third Stage Management Choice
Third Stage Management Choice
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Risk Factors and PPH
Risk Factors and PPH
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Skin-to-Skin Contact
Skin-to-Skin Contact
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Cultural Practices in Third Stage
Cultural Practices in Third Stage
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Oxytocin Release
Oxytocin Release
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Signs of Placental Separation
Signs of Placental Separation
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Flexible Timing
Flexible Timing
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Postnatal Support
Postnatal Support
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Follow-up Communication
Follow-up Communication
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Counseling Referral
Counseling Referral
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Expectant Management
Expectant Management
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Physiologic Management
Physiologic Management
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Iron Supplementation Options
Iron Supplementation Options
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Midwife's Role in Iron Deficiency Anemia
Midwife's Role in Iron Deficiency Anemia
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Client Context for Iron Deficiency Anemia
Client Context for Iron Deficiency Anemia
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Study Notes
Nitrous Oxide for Labour
- Nitrous oxide (N₂O) is a colourless gas used for intrapartum pain relief.
- It's fast-acting, safe, and effective for pain management.
- Clients often report satisfaction when using N₂O, comparable to epidural analgesia.
- Maintaining client mobility while administering N₂O is important.
When Nitrous Oxide is Beneficial
- Clients experiencing intrapartum pain, especially when dilated to >5cm.
- Clients avoiding epidural, or waiting for epidural availability.
- Clients experiencing anxiety during labour.
How Nitrous Oxide Works
- Analgesic effects: Increases endogenous endorphins, dopamine, and opioids in the brain.
- It works in a similar mechanism to morphine.
- Anxiolytic effects: Increases prolactin, decreases cortisol, and activates the GABA-A which is an inhibitory neurotransmitter, effectively reducing stress response.
Benefits of Nitrous Oxide
- Rapid onset (30-50 seconds) and quick offset (1-2 breaths of room air).
- Maintains client mobility.
- Does not affect uterine activity.
- Non-invasive and cost-effective.
Fetal Effects and Risks of N₂O
- No effect on fetal heart rate, umbilical cord gases, or Apgar scores.
- Crosses the placenta; however, the lack of lipid solubility prevents accumulation, and any remaining gas is eliminated when the baby starts to breathe.
Adverse Effects of Nitrous Oxide
- Nausea, dizziness, or vertigo.
- In mixtures of 50% N₂O and 50% oxygen, respiratory depression or diffusion hypoxia might not occur.
How to Administer Nitrous Oxide
- Prepare equipment: Connect regulator, tubing, filter, mask/mouthpiece, and scavenging tube. Confirm sufficient gas in tank.
- Inform client: Instruct client to inhale and exhale into the mask/mouthpiece during contractions and breathe room air between contractions.
- Client to hold apparatus: Instruct client to hold the apparatus themselves. Avoid using straps to hold the mask.
Supplies Needed
- Nitrous oxide tank, regulator, filter, mask/mouthpiece, gas tubing, and scavenging tubing.
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