Pain Management During Labor and Epidural Care
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Questions and Answers

What would the nurse guide a labor coach to do to comfort a woman tensing her muscles with contractions?

  • Engage the patient in conversation.
  • Offer warm liquids to the patient.
  • Encourage the patient to pant. (correct)
  • Assist the patient to the knee-chest position.
  • What assessment should be taken immediately after the anesthesiologist administers an epidural block to a laboring woman?

  • Intravenous fluid flow rate.
  • Blood pressure. (correct)
  • Bladder for distention.
  • Sensation in the lower extremities.
  • Which narcotic antagonist is used to reverse narcotic-induced respiratory depression?

  • Nitrous oxide
  • Hydroxyzine (Vistaril)
  • Phenobarbital
  • Naloxone (Narcan) (correct)
  • What nursing action will be included in the teaching plan for a woman receiving a subarachnoid block before delivery to prevent the associated side effect?

    <p>Lie flat for several hours.</p> Signup and view all the answers

    What is the priority nursing diagnosis for an 18-year-old primigravida who is 4 cm dilated and crying for pain relief?

    <p>Pain related to uterine contractions.</p> Signup and view all the answers

    The nurse who encourages the gate control theory of pain control would advise a laboring woman to use which nonpharmacological method of pain management?

    <p>Massage.</p> Signup and view all the answers

    What is a contraindication to an epidural block?

    <p>Abnormal clotting.</p> Signup and view all the answers

    What may premature bearing down cause when a nurse coaches a primigravida not to do so until the cervix is completely dilated?

    <p>Cervical laceration.</p> Signup and view all the answers

    What should be the patient's rate while performing slow breathing if her baseline respiratory rate is 22 breaths per minute?

    <p>11</p> Signup and view all the answers

    What is the least amount of sensation that one perceives as pain?

    <p>Threshold</p> Signup and view all the answers

    What sign would alert the nurse of the need for pain relief in a laboring patient who is not reporting pain?

    <p>Facial grimacing.</p> Signup and view all the answers

    How will hot and cold applications applied to a laboring patient's abdomen act to control pain?

    <p>By stimulation of large nerve fibers.</p> Signup and view all the answers

    What will the nurse anticipate when a laboring patient registers as having the fetus located in the right occiput posterior (ROA)?

    <p>Severe lower back pain.</p> Signup and view all the answers

    What typical types of classes are available to help expectant parents prepare for parenthood?

    <p>Infant care.</p> Signup and view all the answers

    What breathing techniques would the nurse teach a prenatal patient to help reduce pain during labor?

    <p>Modified pace breathing.</p> Signup and view all the answers

    How does the pain of childbirth differ from other types of pain?

    <p>Childbirth pain is self-limited.</p> Signup and view all the answers

    Which are nonpharmacological forms of pain relief?

    <p>Diversion and distraction.</p> Signup and view all the answers

    Which position(s) and exercise(s) will be beneficial in combating discomfort in the later stages of pregnancy?

    <p>Tailor sitting.</p> Signup and view all the answers

    What major advantages of nonpharmacological pain control methods should the nurse include in the presentation?

    <p>They do not have the potential to cause allergic reactions.</p> Signup and view all the answers

    What interventions are appropriate for the nurse to implement for a woman with epidural anesthesia to prevent injury risks?

    <p>Observe for signs of impending birth.</p> Signup and view all the answers

    What will the nurse include in the educational plan for a woman receiving Fentanyl (Sublimaze) during labor?

    <p>Duration is short.</p> Signup and view all the answers

    The amount of pain a person is willing to endure is referred to as ______________ ______________.

    <p>pain tolerance</p> Signup and view all the answers

    The massage technique that stimulates the large-diameter fibers in order to block impulses from the small-diameter fibers is ____________________.

    <p>effleurage</p> Signup and view all the answers

    The ______________ ___________, also called the psychoprophylactic method, is the basis of most childbirth preparation classes in the United States.

    <p>Lamaze method</p> Signup and view all the answers

    Study Notes

    Pain Management During Labor

    • Encourage panting to help women relax abdominal muscles during contractions; it serves as a distraction from pain.
    • Blood pressure must be monitored every 5 minutes after administering an epidural to assess maternal stability.
    • Naloxone (Narcan) is the narcotic antagonist used to reverse respiratory depression caused by opioids.

    Epidural Care and Side Effects

    • After a subarachnoid block, advise patients to lie flat for several hours to minimize the risk of postspinal headache.
    • Pain management through effective nursing intervention is crucial, especially for primigravida patients experiencing severe pain.

    Nonpharmacological Techniques

    • Massage is recommended as a nonpharmacological method aligned with gate control theory to diminish pain perception during labor.
    • Hot and cold applications work by stimulating large-diameter nerve fibers, effectively reducing pain signals transmitted through smaller nerve fibers.

    Fetal Position and Labor

    • Right occiput posterior (ROA) fetal position may lead to severe back pain due to pressure on the mother’s sacrum during contractions.

    Childbirth Preparation Classes

    • Traditional prenatal classes cover essential topics like infant care, breastfeeding, and managing gestational diabetes.
    • Breathing techniques beneficial during labor include first-stage breathing, abdominal breathing, modified pace breathing, and patterned paced breathing.

    Characteristics of Childbirth Pain

    • Childbirth pain is a normal process, often declines following birth, and can be alleviated by changing positions.
    • Pain tolerance varies among individuals, while pain threshold is the minimum perception of pain experienced.

    Nonpharmacological Pain Relief Advantages

    • Nonpharmacological methods do not dull the excitement of childbirth and are less likely to cause allergic reactions.
    • They do not typically slow the labor process and can be initiated at any stage of labor.

    Monitoring and Safety

    • Assess leg movement and sensation before ambulating patients with epidural anesthesia to prevent falls and injuries.
    • Look for signs of impending birth, including bloody show, perineal bulging, and crowning in patients receiving epidural care.

    Opioid Administration Education

    • Fentanyl, used for labor pain relief, has a rapid onset and short duration; educate patients about its side effects and differences from other narcotics.

    Key Terms

    • Pain Tolerance: The maximum amount of pain that a person can endure.
    • Effleurage: A massage technique that blocks small-diameter pain fiber impulses through large-diameter fiber stimulation.
    • Lamaze Method: The psychoprophylactic childbirth preparation technique prevalent in the U.S. focusing on breathing and relaxation.

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    Description

    This quiz explores the key concepts of pain management techniques during labor, focusing on both pharmacological and nonpharmacological strategies. It also discusses the administration and care associated with epidurals, including monitoring and interventions to enhance maternal comfort.

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