2.1 Nursing Management of Pain During Labor and Birth

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Questions and Answers

What is a primary advantage of pharmacologic methods of pain management during labor?

They can be carefully timed to align with labor progression. (correct)

They require no medical supervision or monitoring.

They are always non-invasive and easy to administer.

They completely eliminate all sensations of pain.

How do regional anesthesia techniques affect the fetus during labor?

They can cause temporary respiratory depression in the newborn. (correct)

They lead to a more prolonged labor process.

They have no effect on fetal heart rate.

They are associated with increased fetal movement.

Which scenario best indicates the need for general anesthesia during childbirth?

Situations where local anesthesia is ineffective.

Desire for complete awareness during the procedure.

Preference for quick labor pain management.

Emergency cesarean section with rapid delivery needs. (correct)

What is the key difference between analgesics and anesthetics in the context of labor pain management?

Analgesics minimize pain without affecting consciousness, while anesthetics may lead to loss of sensation. Signup and view all the answers

Which of the following factors is most likely to influence labor pain among women?

Cervical readiness and fetal position. Signup and view all the answers

What effect does the gate control theory suggest in relation to pain management during labor?

Pain perception can be blocked at the spinal cord level. Signup and view all the answers

What is the main reason for using pharmacologic methods during labor?

To make the mother more comfortable and relaxed Signup and view all the answers

How can medications administered during labor affect the fetus?

They may lead to fetal acidosis if the stress response is not controlled. Signup and view all the answers

When is general anesthesia typically indicated during childbirth?

When immediate delivery is required, such as in an emergency cesarean Signup and view all the answers

What distinguishes an analgesic from an anesthetic?

An analgesic blocks pain, while anesthetics block pain and motor responses. Signup and view all the answers

Which regional anesthesia technique involves injecting anesthetic into the subarachnoid space?

Subarachnoid (spinal) block Signup and view all the answers

What is a significant risk associated with the sluggish GI tract during pregnancy?

Increased risk of vomiting and aspiration Signup and view all the answers

Why should narcotic analgesics be avoided if birth is anticipated within 1 hour?

They can cause respiratory depression in the newborn. Signup and view all the answers

What is the consequence of aortocaval compression during pregnancy?

Increased risk of hypotension and shock Signup and view all the answers

What is a common use for adjunctive drugs during labor?

To relieve nausea and vomiting Signup and view all the answers

Which of the following are advantages of nonpharmacologic pain management during childbirth?

They do not slow labor if they provide adequate pain control. Signup and view all the answers

What is the primary difference between analgesics and anesthetics?

Analgesics provide pain relief without loss of consciousness, while anesthetics induce loss of sensation. Signup and view all the answers

Which substance is classified as a regional anesthetic?

Epidural block Signup and view all the answers

What is a potential effect of pharmacologic pain management on the fetus?

Decreased oxygen levels due to maternal drug effects. Signup and view all the answers

Which breathing technique is specifically associated with the second stage of labor?

Patterned-paced breathing Signup and view all the answers

What should a nurse do first when identifying signs of hyperventilation in a laboring woman?

Instruct her to breathe slowly, especially when exhaling. Signup and view all the answers

Which of the following is NOT a method of nonpharmacologic pain relief?

Epidural injection Signup and view all the answers

What is the nursing role in nonpharmacologic pain management during labor?

Determine if the patient has attended childbirth preparation classes. Signup and view all the answers

What is an indication for using general anesthesia during childbirth?

Immediate delivery is required due to fetal distress. Signup and view all the answers

Which of these measures is NOT a relaxation technique for nonpharmacologic pain management?

Epidural anesthesia Signup and view all the answers

Study Notes

Pregnancy and Analgesia/Anesthesia

Pregnant women are at higher risk of hypoxia, vomiting, aspiration, hypotension, and shock due to physiological changes.
Fetal safety is paramount when considering analgesia and anesthesia.
Medications can help mothers relax, cope with labor, and reduce stress response, which can prevent fetal acidosis.
However, medications affect both mother and fetus, and can slow labor if given too early.

Types of Pain Relief

Narcotic (opioid) analgesics are used for pain relief, but should be avoided if birth is expected within 1 hour.
Narcotic antagonists are used to reverse respiratory depression.
Adjunctive drugs are used to relieve nausea and vomiting.

Regional Anesthesia

Regional anesthesia involves placing anesthetics in the epidural or subarachnoid space.
This targets the meninges around the spinal cord which include: dura mater, arachnoid mater, and pia mater.

Key Differences

Analgesics block pain only.
Anesthetics block both pain and motor responses.

Anesthesia for Childbirth

Types include: local infiltration, pudendal block, epidural block, subarachnoid (spinal) block, and general anesthesia.

General Anesthesia

Used in emergency Cesarean births or when a block is contraindicated.

Nonpharmacologic Pain Management

Advantages: safe for mother and fetus, no risk of allergy or adverse drug effects, does not slow labor.
Methods: relaxation techniques, skin stimulation, effleurage, sacral pressure, thermal stimulation, positioning, diversion and distraction, and breathing.

Breathing Techniques

First stage: slow-paced, modified-paced, patterned-paced (constant or stairstep).
Second stage: used when pushing.

Hyperventilation

Signs and symptoms: dizziness, tingling in hands and feet, muscle spasms, numbness around the nose and mouth, vision blurring.
Corrective measures: breathe slowly, breathe into cupped hands, use a moist washcloth, hold breath for a few seconds.

Nurse's Role in Nonpharmacologic Techniques

Determine if the patient attended childbirth preparation classes.
Identify signs of tension.
Minimize environmental irritants.

Pharmacologic Pain Management

Includes analgesics (systemic), adjunctive drugs, and anesthetics (regional and general).

Childbirth Preparation Classes

Classes cover: changes of pregnancy, fetal development, prenatal care, hazardous substances, nutrition, common discomforts, exercise, and coping with labor.

Pain During Childbirth

Differs from other pain in that: it's part of a normal process, the woman has time to prepare, and it's self-limiting.

Factors Influencing Labor Pain

Pain threshold, sources of pain during labor (cervical readiness, pelvis, labor intensity, fatigue), fetal position, and central nervous system factors (gate control theory, endorphins).

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Description

This quiz covers important aspects of analgesia and anesthesia during pregnancy, focusing on the physiological changes that can affect both the mother and fetus. Explore types of pain relief, regional anesthesia techniques, and key differences between analgesics and anesthetics. Ensure an understanding of fetal safety while managing maternal comfort.