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