OB ATI chapter 12 Flashcards Quizlet - Obstetric PDF

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Notes on Obstetric course per chapter listed in the title. Comprehensive notes to study with per ati standards to use for studying....

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8/16/2021

OB ATI chapter 12 Flashcards | Quizlet

OB ATI chapter 12 Terms in this set (15) Internal visceral pain Sources of pain during the stages of labor (FIRST STAGE)

Dilation, effacement, and stretching of the cervix. Distention of the lower segment of the uterus. Contractions of the uterus with resultant uterine ischemia.

Somatic Pressure and distention of the vagina and the perineum, described by the client SECOND STAGE

as "burning, splitting, and tearing." Pressure and pulling on the pelvic structures (ligaments, fallopian tubes, ovaries, bladder, and peritoneum). Lacerations of soft tissues (cervix, vagina, and perineum).

Expelling of the placenta THIRD STAGE

Uterine contractions. Pressure and pulling of pelvic structures.

FOURTH STAGE

Distention and stretching of the vagina and perineum incurred during the second stage with a splitting, burning, and tearing sensation.

-child birthing preparation methods such as Lamaze, Bradley, Dick-Read methods and/or breathing methods Nonpharmacological Pain Management

-Sensory stimulation strategies -Cutaneous strategies -Frequent maternal position changes

Pharmacological Pain Management

Sedatives, Opioids, Phenothiazine, Epidural and spinal regional analgesia

-Sedatives (barbiturates) such as secobarbital (Seconal), pentobarbital (Nembutal), and phenobarbital (Luminal) Sedatives

are not typically used during birth, but can be used during the early or latent phase of labor to relieve anxiety and induce sleep.

Opioid analgesics such as meperidine hydrochloride (Demerol), fentanyl (Sublimaze), butorphanol (Stadol), and Opioid analgesics

nalbuphine (Nubain) act in the CNS to decrease the perception of pain without the loss of consciousness. The client may be given opioid analgesics IM or IV, but the IV route is recommended during labor because action is quicker.

Phenothiazine medications such as promethazine (Phenergan) or Phenothiazine

hydroxyzine (Vistaril) can control nausea and anxiety. They do not relieve pain and are used as an adjunct with opioids - can cause dry mouth and sedation

Epidural and spinal regional analgesia consists of using analgesics such as fentanyl (Sublimaze) and sufentanil (Sufenta), which are Epidural and spinal regional analgesia

short-acting opioids that are administered as a motor block into the epidural or intrathecal space without anesthesia. These opioids produceregional analgesia providing rapid pain relief while still allowing the client to sense contractions and maintain the ability to bear down.

Regional blocks Pharmacological anesthesia

Epidural blocks Spinal blocks

Pudendal block consists of a local anesthetic such as lidocaine (Xylocaine) or bupivacaine (Marcaine) being administered transvaginally into the space in front of the pudendal nerve. This type of block has no maternal or Regional block

fetal systemic effects, but it does provide local anesthesia to the perineum, vulva, and rectal areas during delivery, episiotomy, and episiotomy repair. It is administered during the second stage of labor 10 to 20 min before delivery providing analgesia prior to spontaneous expulsion of the fetus or forceps- assisted or vacuum-assisted birth

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OB ATI chapter 12 Flashcards | Quizlet An epidural block consists of a local anesthetic bupivacaine (Marcaine) along with an analgesic morphine (Duramorph) or fentanyl (Sublimaze) injected into the epidural space at the level of the fourth or fifth vertebrae. This eliminates all sensation from the level of the umbilicus to the thighs, relieving the discomfort of uterine Epidural block

contractions, fetal descent, and pressure and stretching of the perineum. It is administered when the client is in active labor and dilated to at least 4 cm. Continuous infusion or intermittent injections may be administered through an indwelling epidural catheter. Patient-controlled epidural analgesia is a new technique for labor analgesia and is becoming a favored method of acute pain relief management for labor and birth.

Spinal block consists of a local anesthetic that is injected into the subarachnoid space into the spinal fluid at the third, fourth, or fifth lumbar interspace. This can be done alone or in combination with Spinal block

an analgesic such as fentanyl (Sublimaze). The spinal block eliminates all sensations from the level of the nipples to the feet. It is commonly used for cesarean births. A low spinal block may be used for a vaginal birth, but is not used for labor. A spinal block is administered in the late second stage or before cesarean birth.

General anesthesia is rarely used for vaginal or cesarean births when there are no complications present. It is only General Anesthesia

used in the event of a delivery complication or emergency when there is a contraindication to nerve block analgesia or anesthesia. General anesthesia produces unconsciousness

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