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53 Cards in this Set
- Front
- Back
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what are the sources of pain during labor (4)
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cervical dilation&effacement
uterine muscle cell hypoxia stretching of uterine segment pressure on structures |
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what classes discourage the use of meds during labor
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bradley
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effleurage
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back rub
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used for perineal support
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birthing ball
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when is effleurage used
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early to mid labor
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which drugs are used for pain relief and sedation only
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demerol
nubain stadol |
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visteral uses
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anxiety
sedation |
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phenargan uses
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anxiety, sedation, antiemetic
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what is one issue with all systemic meds
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they cross placenta within minutes
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alteration in maternal state will do what
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affect fetus
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why do meds remain in fetal system longer than maternal
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immature liver and kidneys (recycling and swallowing)
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will always change with medication use
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changes on strips
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when are meds usually given
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active labor (4-7cm)
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should never be administered to someone with drug hx
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nubain and stadol
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baseline FHR
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110-160
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reactive strips
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accels
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what are the things that need to be present with fetal before administering meds
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FHR b/t 110-160
reactive strip average variability no decels |
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what should be known before getting orders
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contraction pattern
cervical dilation and effacement fetal presenting part (not bree) station of presenting part |
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what does bishops score evaluate
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effacement and dilation
station of presenting part cervical consistency&position |
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when are ataractics (analgesic potentiators) used
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early latent phase
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what do ataractics do
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decrease n/v
anxiety and amt of opiod needed |
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what are the common ataractics
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phenergan
vistaril largon sparine |
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when are sedatives used
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false labor or very early labor
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what is the purpose of sedatives
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relaxation and sleep
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what are the common sedatives
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seconal and ambien
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when are narcotics (opiods) used
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active phase (4-7)
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narcotics that have ceiling effect
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stadol and nubain
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what is a ceiling effect
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1st dose most effective
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why is demoral less common
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bc it causes neonatal depression
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50-100x more potent than MS
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fentanyl
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narcotic antagonists
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narcan
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temporary and reversible loss of senstation by injecting anesthetic agent
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regional anesthesia
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what does a regional anesthesia prevent
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nerve impulses
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what are the types of regional anesthesia
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epidural
spinal combined |
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what are the disadvantages of epidural
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maternal hypotension
diminished bladder sensation |
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what impedes progress during labor
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full bladder
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should be given before epidural
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bolus of IV fluids (1-2L)
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contraindications for epidural
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pt refusal
lumbar infection coag disorders anticoag therapy allergies to med herpes tumor at inj site vertebral anomalies MVA too short |
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what should the plt count be before given an epidural
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100,000
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injection of anesthetic agent into epidural space for pain relief in labor
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epi block
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where is epi block given
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around l4 l5
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what is the epi med absorbed by
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nerve roots
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usually given with C/S
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spinal block
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used with spinal to prevent CSF leakage
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smaller needle
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SE of CSF leakage
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headache
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used in the second stage of labor and last about 3-90 minutes
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pudendal block
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anesthetic agent inj into intracutaneous, subQ, or intramuscular area of the perineum
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local anesthesia
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when are local anestheisa given
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prior to episiotomy or repair
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general anesthesia agents used by IV
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pentothal
ketamine |
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complications of general anesthesia
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fetal depression
uterine relaxation potential for resp complication |
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example of antacid
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alka seltzer or bicitra
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shortens gastric emptying
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reglan
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used to apply pressure until pt is intubated to prevent aspiration of secretions in the lung
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cricoid pressure
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