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23 Cards in this Set

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What are the causes of pain in 1st stage?
1st stage: dilatation of cervix; when uterus contracts >hypoxia of miometrium. As baby descends, pressure on surrounding tissues.
What are the causes of pain in 2nd stage?
Hypoxia of muscle cells, pressure on adjacent tissues, distention of vagina and perineum.
causes of pain in 3rd stage?
Hypoxia of muscles, pressure on adjacent tissues, cervical dilatation again for placental delivery.
causes of pain in 4th stage?
hemorhoids, episiotomy, post uterine contractions, edema, hematomas.
How do systemic drugs effect baby?
effects last a few days in babies - not used as much - effect on baby, mother, contractions should be considered. Cause dec sucking effort; dec overall activity; dec visual attentiveness are s/s of systemic drugs in mother.
What are considerations when giving systemic drugs to mother?
Usually give IV - quicker
Give slowly during contraction when blood flow to placenta is dec. Give over 3 contraction - baby doesn't get as much.
What could happen if give systemic drugs too fast?
could put mom in respiratory distress.
What other considerations are necessary before giving drug?
make sure mom is in a good pattern of labor before giving. IF give too early or too much can change pattern of delivery. Don't want drug to peak at time of delivery - can happen if given late.
What is the antedote for systemic drugs?
narcan
Antiemetics -
phenergan: Dec. nausea. Together with analagesics can relieve anxiety, nausea,potentiate narcotic. Antiemetics bad for baby > depressed symptoms, hypothermia, hypotonia.
Sedatives -
Seconal - used with false labor; poorly metabolized.
Amnesic drugs -
Scopolamine - put them to sleep - dont' see alot women want to be seen
Anestheia:
local injected into tissue for episiotomy and repair. Least amount she can have.
General anesthesia:
not used alot mostly emergency CSection. Can put mom and baby to sleep.
What are some examples of general anesthesia drugs?
Penthrane
Trilene
both in 1st stage.
What are some situations you would need general anesthesia?
If baby breech to relax uterus.
Aversion, turn baby - may need uterus relaxed
What should you watch for if give general anesthesia?
Hemorrhage - uterus relaxes; don't need these drugs if hemorrhage a problem - these work by vasal dilatation.
Regional drugs are given how?
Para-cervical 1st stage
epidural - 2nd stage
What are some factors about epidural?
Better effect; loading dose of 8cc. Higher, risk of going into subarachnoid space.
What are some benefits of caudal?
good for mom with debilitations, good for baby becasue don't effect as much. Can back off med so she can push.
What are some facts about caudal?
Caudal lower, 1 cc, risk of puncturing fetal head or bowel of mom. 1st stage > 2nd stage.
What is a spinal (saddle block - low spinal)?
Given in subarachnoid space. 2nd stage med.
When is a pudendal block given?
2nd Stage.