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Maternity Nursing Ch 9-10-11 questions with answers.
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Maternity Nursing Ch 9-10-11 questionswith answers.
How does labor pain differ from other types of pain? ANS - -Associated with normal physiological
process, not a warning signal of injury.
-Increase in intensity of pain is good, as it is a sign of approaching birth.
-Occurs in a predictable pattern after the onset of labor pain.
-There is a respite from pain between contractions.
-Because it is predictable, women can prepare for and better cope with the pain.
Where does pain associated with the first stage labor originate from? ANS - Stretching required to
efface and dilate the cervix stimulates pain receptors in cervix and lower uterine segment.
Where does pain associated with the second stage of labor originate from? ANS - Pressure on the
perineum and birth canal as the fetus descends
Characteristics of labor pain during the first stage ANS - -Similar to other types of abdominal pain
-Often diffuse in nature
-Occurs in lower abd. and may be referred to lower back, buttocks and thighs.
-Contractions "wavelike," with some waves stronger than others
-Pain begins as cramping, increases in strength to the peak of the contraction.
Psychosocial influences on labor pain ANS - -Anxiety
-Culture
-Circumstances surrounding birth experience
-Planned vs. unplanned pregnancy
-Child wanted or unwanted
-Birth term or pre-term
,-Fetus living or dead
Two general concepts related to pain ANS - Threshold and Tolerance
Threshold ANS - Level of pain necessary for an individual to perceive pain
Tolerance ANS - Ability of an individual to withstand pain once it is recognized
Variables affecting perception of labor pain ANS - -younger women more likely to report severe pain
-Women delivering for the first time report more intense levels of pain
-High levels of anxiety and fear result in higher levels of perceived pain
-Physical conditioning results in lower levels of pain
-The extent of the woman's knowledge of labor and whether or not she has realistic expectations can
affect her perception of the pain as well as her ability to cope with it.
Physiologic factors that affect labor pain ANS - -Longer labor = more extreme pain
-Obstructed or dysfunctional labor = more pain
-Oxytocin/petocin results in more intense contractions
-Back labor is intensely painful
Obstructed labor ANS - Can result from fetopelvic disproportion and abnormal fetal positions
Back labor ANS - Perceived as being intensely painful, even excruciating. Some women may report it
feels as if their back is breaking in two. Pain may not completely resolve between contractions.
The role of the nurse in labor pain management ANS - -Inform the woman of pain management options
-Be supportive of her choices
-Remember she has the right to change her mind at any time
-Do not underrate the severity of her pain when compared with her pain ratings
, Accept her description of the severity of the pain even when she may not appear to be in pain
-Maintain a non-judgmental attitude, regardless of your own feelings on the subject of pain control
during labor
-Careful pain assessment is required, regardless of whether the patient is stoic or vocal when it comes to
her pain.
-Teach the unprepared patient what to expect and assist her in coping when she presents in labor.
Nonpharmacologic Interventions for Labor Pain ANS - -Continuous Labor Support
-Patterned Breathing
-Effleurage
-Water therapy
-Imagery
-Hypnosis
-Intradermal water injections
-Acupressure & Acupuncture
Continuous Labor Support ANS - Performed by trained nurse or doula. Affective in increasing coping
ability during labor. Benefits include fewer request for pain meds, fewer obstetric interventions,
increased perception of personal control, higher satisfaction with labor experience and lower rate of C-
section. Addresses the emotional and spiritual aspects of labor. Continuous support not always available
in busy L&D settings. If a woman is interested in continuous labor support, the nurse may encourage her
to hire a doula.
Comfort Measures during labor ANS - Lip balm and ice chips/lollipops/clear liquids if allowed.
Frequent linen changes if soiled with sweat or body fluids.
Perineal care with warm water after restroom use and before linen changes.
The importance of relaxation during labor ANS - Anxiety/apprehension results in muscle tensing, which
can slow labor process and decrease oxygen to the fetus. State of relaxation allows her to work with her
body to facilitate labor.
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