Vag and C-section PPT McDizzle's lecture Flashcards Preview

Principles II- Josh > Vag and C-section PPT McDizzle's lecture > Flashcards

Flashcards in Vag and C-section PPT McDizzle's lecture Deck (78)
Loading flashcards...
1

ACOG

American Congress of Obstetricians & Gynecologist

2

on 1993 the ACOG committee on pain relief during labor number 118 stated what?

".... maternal request is sufficient justification for pain releif during labor...."

3

ASA

American Society of Anesthesiologist (aka Anesthesiologist are a Sublevel of Anesthetists)

4

Ingards to Mcd's research on intrathechal and eidural analgesia he found out what?

that the length of labor was NOT prolonged using intrathechal or epidural opiods, and may shorten the 1st stage of labor in both primi and multiparious women.

5

Regional anesthesia for child bearing is philosophy both _____ and _____

-Safe
-Participatory (providing the opportunity for individual participation )

6

What occurs in the 1st stage of labor (5 main body changes)

- Pressure on nerve endings of the uterus
-Contraction of an ischemic myometrium and cervix
-Vasoconstriction
-inflammatory changes
-Dilation of the cervix and lower uterine segment
( how to remember-- 1st
the PRESSURE on the nerve ending of the uterus cause VASOCONSTRICTION, which causes the contraction of an ISCHEMIC MYOMETRIUM AND CERVIX, which causes INFLAMMATORY CHANGES, and thus DILATION of the cervix and lower uterine segment)
I dunno maybe it will help???

7

What causes the 1st stage perceptions?

result of dilation, distention, and stretching of the cervix and lower uterine segment during contraction.

8

What Causes perception during the 2nd and 3rd stages of labor?

-Traction on the pelvic peritoneum and uterine ligaments
-Tension on the bladder and rectum
-tension on the ligamnets, fascia and muscles of the pelvis
-Pressue on lumbrosacral plexus
(how to remember- stage 2 and 3 the baby is moving down so the pain is lower and it STRETCHES everything by pulling it down)

9

************************************************
Somatic pain in the 2nd stage of labor via vaginal and perineal in orgin are from what nerves

pudendal nerves S2-4

10

**************************************************
What dermatomes cover the perineum

S2-S4

11

**********************************************
what ligaments are stretched or placed under tension in stage 2 and 3 of labor

-Round ligaments
-Superior pubic ligaments
-Broad ligament
-Cardinal ligament

12

What factors can influance the perception of Pain r/t labor

-pain tolerance
-Pain threshold
-Individual factors (Intrapersonal, interpersonal, societal)
-Supportive structures
-Cultural factors

13

What are the 3 NON-pharmacological pain releif THEORIES for prepared child birth?

Grantly Dick-Reed (childbirth without fear)
Lamaze (Psychoprophylaxis)
Fredrick Le Boyer (Birth without Violence)

14

**************************************************
**************************************************
explain Grantly Dick-Reed non-pharm pain relief for birth

(Childbirth without Fear)
-Natural childbirth
-Believed that pain was a result of not knowing what is happening during labor and delivery

15

*************************************************
Explain Lamaze non-pharm pain relief for birth

(Psychoprophylaxis)
-Relaxation and breathing techniques

16

***********************************************
Explain Fredrick Le Boyer non pharm pain relief for birth

(Birth without Violence)
- gentle approach to birthing using "bath" placing women into a bath to ease the transition from the womb to the real world

17

What are 4 other non pharm pain releif for labor

Hypnosis
TENS
Acupunture
Alternative birthing options

18

Advantages of systemic analgesics for labor.
(5)

Ease of use
Staffing
no IV required (IM)
Minimal monitoring
Few complications

19

Disadvantages of systemic analgesics for labor (5)

effectivness
depression
respiratory decreases
N/V
Fetal depresion

20

************************************************
Main disadvantage of systemic analgesics for labor

Don't work very well

21

*************
Opioids for labor with potency

Demerol 0.1 (1/10)
Morphine 1 (of historic interest only)
Alfentanil 10-5
Fentanyl 75-125
Sufentanil 500-1000

22

Opioid agonist/Antagonists for labor pains (with potency if u care)

-Nalbuphine (nubain) 0.7-0.8
-Butorphanol (Stadol) 5
-Pentazozine (Talwin) 30-60 mg = 10mg morphine

23

************************************************** Why is stadol out of favor for use in some OB settings?

Due to a 75% incidence of transient sinusoidal fetal heart pattern (considered benign)
can cause narcotic withdrawl in narcotic addicts

24

Sedatives for Vaginal OB labor (3)

Phenothiazines
Benzodiazepines
Butyrophenones

25

*************************************************
Examples of Phenothiazines for sedatives

Thorazine
phenergan

26

*************************************************
Examples of Benzodiazapines for sedatives

Versed
Valium

27

*************************************************
Examples of Butyrophenones for sedatives

Haldol
droperidol

28

Anticholinergics

Atropine
Scopolamine
Glycopyrrolate

29

*************************************************
What to remember about robinul (glycopyrrolate)

it does NOTcross the BBB

30

what are 3 periphreal nerve blocks for L&D

field block
Pudendal nerve block
Paracervical Block