Pain Management Chapter 12 PDF
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Northwestern State University
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Summary
This document provides information on pain management during labor. It includes various approaches to pain relief, both non-pharmacological and pharmacological, and potential side effects. The document also addresses nursing actions related to urinary retention and hypotension.
Full Transcript
**Chapter 12: Pain Management ** Indications of pain: - Behavioral - Increased BP, tachycardia, hyperventilation - N/V Non-pharmacological pain relief: - Lamaze - Blowing in paper bag or hands for hyperventilation - Hypnosis - Aromatherapy, music, low lighting - Back rub/m...
**Chapter 12: Pain Management ** Indications of pain: - Behavioral - Increased BP, tachycardia, hyperventilation - N/V Non-pharmacological pain relief: - Lamaze - Blowing in paper bag or hands for hyperventilation - Hypnosis - Aromatherapy, music, low lighting - Back rub/massage - Sacral counterpressure - The heel of hand or fist against sacral area to counteract low back pain. - Heat or cold - TENS, hydrotherapy, acupressure - Supine with wedge under one hip Pharmacological pain relief: - Sedatives - Not typically given. - Neonate resp distress (don't give within 12-24 hrs. prior to birth) - Ambulation falls risk. - Opioids - During early parts of active labor - Butorphanol/nalbuphine - Pain relief without resp depression - A.E. - Neonate resp distress - Increased N/V, risk for aspiration - Sedation, AMS - Tachycardia, hypotension - Decreased FHR - If given: - Continuous FHR monitoring - Vitals and contraction patterns - Give antiemetics - Naloxone: have on hand-opioid antagonist - Metoclopramide - Nausea and anxiety control - May cause dry mouth and sedation - Provide ice chips or mouth swabs - Epidural block - Must be 4+cm dilated - A.E. - Hypotension - Fetal bradycardia - Fever - Itching - Urinary retention - Unable to bear down - Nursing actions - Bolus IV fluids to offset hypotension - Sitting or side-lying sims position with back curved, remain side lying - If orthostatic hypotension occurs: - IV vasopressor (epi) - Position laterally - Increase IVF - Initiate 02 - Spinal anesthesia (block) - Usually for c-section - A.E. - Hypotension - Fetal bradycardia - Unable to bear down - HA - May cause maternal bladder and uterine atony - Nursing actions: - Vitals q10 minutes - If hypotension occurs: - Bolus IVF - Position laterally - Increase IVF - Initiate 02 - Assess contraction, continuous FHR - If HA from CSF leakage - Supine - Bedrest/dark room - Give oral analgesics, caffeine, fluids
