Introduction to Maternity and Pediatric Nursing Chapter 7

Introduction to Maternity and Pediatric Nursing Chapter 7 what do c-section classes help with Ans- help understand the reasons for this method of delivery and anticipate what is likely to occur during and after surgery what exercises can help prepare the woman's muscles for the demands of birth Ans- pelvic rock, tailor sitting, and shoulder circling how does childbirth pain differ from other pain Ans- -it is part of a normal birth process -has several months to prepare for pain management -self limiting and rapidly declines after birth what is pain threshold Ans- (pain perception) the least amount of sensation that a person perceives as painful what is pain tolerance Ans- the amount of pain one is willing to endure what are different sources of pain during labor Ans- -dilation and stretching -reduced uterine blood supply during contractions (ischemia) -pressure of the fetus on pelvic structures -stretching of the vagina and perineum what is the gate control theory Ans- -explains how pain impulses reach the brain for interpretation -pain is transmitted through small diameter nerve fibers however, the stimulation of large diameter nerve fibers temporarily interfere with the conduction of impulses through small diameter fibers. -techniques to "close the gate" or stimulate large fibers include: massage, palm and fingertip pressure, heat/cold applications what are advantages of non pharmacological pain management Ans- -do not harm mother or fetus -do not slow labor if they provide adequate pain control -carry no risk for allergy or adverse drug effects what are endorphins Ans- natural body substances similar to morphine -endorphin levels increase during pregnancy and peak during labor. That is why pregnant women need less anesthesia or analgesics what is the dick-read method Ans- -concept of fear, tension, pain cycle -he believed that fear of child birth contributed to tension which resulted in pain what is the bradley method Ans- -"husband coached childbirth" -first to include the father as a part of labor -slow abdominal breathing and relaxation techniques lamaze method Ans- -basis of most child birth classes in the USA -uses maternal techniques that condition the women to respond to contractions with relaxation rather than tension what are non pharmacological pain relief measures Ans- relaxation techniques skin stimulation effleurage sacral pressure thermal stimulation positioning diversion and distraction breathing what is the effleurage method Ans- stimulates the large diameter fibers that inhibit pain -strokes abdomen in circular movement during contraction what is sacral pressure Ans- firm pressure against the lower back helps relieve pain of back labor what is thermal stimulation Ans- heat or cool cloth what does positioning help relieve Ans- muscle fatigue and strain helps promote normal mechanisms of labor what are signs and symptoms of hyperventilation Ans- dizziness tinging of hands and feet cramps and muscle spasms of hands numbness around nose and mouth blurring of vision what are corrective measures for hyperventilation Ans- breathe slowly breathe into cupped hands moist washcloth over mouth and nose while breathing paper bag what do pharmacological methods include for labor Ans- analgesics adjunctive drugs what do adjunctive drugs do Ans- improve the effectiveness of analgesics or to counteract the side effects of anesthetics what are analgesics Ans- systemic drugs (affect entire body) that reduce pain without loss of consciousness what are anesthetics Ans- cause loss of sensation especially of pain what are regional anesthetics Ans- block sensation from a localized area without causing a loss of consciousness what are general anesthetics Ans- systemic drugs that cause a loss of consciousness and sensation of pain relationship of pregnancy to analgesia and anesthesia Ans- -pregnant women at higher risk for hypoxia -sluggish GI tract can result in increased risk of vomiting and aspiration -aortocaval compression increases risk of hypotension and shock -effect on fetus must be considered what are advantages of pharmacological methods Ans- -allows mother to be more comfortable -increased relaxation will aid in her ability to work through contractions -lessens "stress response" which if not controlled could lead to fetal acidosis what to consider for pharmacological methods during labor Ans- -2 people are being medicated -must be considered for its potential impact on fetus -can slow labor if given too early what are narcotic (opioid) analgesics Ans- do not provide complete pain relief during labor but they do help the women cope with pain what are the membranes around the spinal cord called what layers do they have Ans- -meninges -dura mater arachnoid mater pia mater what are different types of anesthesia during childbirth Ans- anesthetic method local infiltration pudendal block epidural block subarachnoid (spinal) block general anesthesia what is given for an episiotomy when the fetal head is visible Ans- local infiltration; injection in perineal area what is pudendal block Ans- -used for vaginal births -adequate anesthesia for episiotomy and most low forceps birth -does not block pain from contractions and is given before birth when is general anesthesia necessary Ans- -emergency c section