OB 4280 Sherpath_Week 2
Epidural Contraindications, A/E
- Loss of feeling in lower areas of body but remains awake and alert; able to bear down and push - Contraindicated in coagulation defects, uncorrected hypovolemia, infection in the area, related allergy, or fetal condition - A/E: HPN, bladder distention, prolong 2nd stage of labor, migration of epidural catheter, an fever
CSE
- contractions are felt but no pain - rapid onset without sedation, allows woman to walk & no hypotension
List relevant patient cues in the order the nurse recognizes them in a primipara during labor as the patient progresses from the first stage of labor to the second stage of labor.
- mild contractions at home - cervix is thick and 50% effaced - contractions become closer & coordinated - cervix 6 cm dilated - bloody show and report of rectal pressure
Place the steps in the order in which they would be applied to perform Leopold maneuvers.
- palpate uterine fundus - palate for the fetal back - palpate suprapubic area - determine if head is flexed or extended
A laboring patient reports moderate back pain. Her partner rubs her lower back and reminds her to look at the teddy bear they bought for the newborn. Which relaxation techniques are being used? **Select all A. Massage B. Focal Point C. Hydrotherapy D. Acupuncture E. Mental Imagery
A, B
Which are the advantages of external electronic fetal monitoring (EFM)? **Select all A. Suitable for most patients in labor B. Visualization of heart rate pattern C. Allows measurement of contraction intensity D. Uninterrupted by fetal or patient movement E. Allows mobility if connected to mobile unit
A, B, E
A woman is visibly anxious, refuses position changes in labor, and verbalizes, "I'm afraid I'm going to die." The nurse knows it is important to help the woman relax through effective coaching because of which responses to stress experienced in labor? ***Select All*** A. Fetal intolerance to labor B. Bradycardia related to a vagal response C. Release of catecholamines in the mother's body D. Inhibited uterine contractions because of decreased blood flow to the placenta E. Umbilical cord prolapse
A, C, D
Which nursing actions are appropriate when the fetal monitor shows a pattern of late decelerations? **Select all A. D/C oxytocin B. Provide water to patient C. Administer O2 D. Reposition patient onto her side E. Continue monitoring and document findings
A, C, D
When teaching a childbirth class for first-time parents, the nurse includes which benefits of breathing techniques used during labor? **Select all A. Decrease sensation of pain B. Requires increased energy with continued use C. Provides different focus during contractions D. Can substitute fo pharmacologic intervention E. Used with other nonpharmacologic techniques
A, C, D, E
Which factors could improve a woman's experience with pain during labor? **Select all A. Cultural B. Financial C. Environmental D. Psychological E. Physiologic
A, C, D, E
The nurse understands that which hormonal changes are thought to encourage the onset of labor? **Select all A. Rising estrogen counteracts relaxing effect of progesterone on the uterus B. FSH is secreted in large quantities by Anterior Pit C. Prostaglandins are secreted by fetal membranes preparing the uterus D. The fetus secretes cortisol which may act as additional uterine stimulant E. TSH is enhanced and helps uterus contract F. Oxytocin is secreted by mother, causing contractions
A, C, D, F
The nurse is caring for a woman in the second stage of labor whose contractions have become more intense. What actions could the nurse take to assist this woman? **Select all A. Model modified paced breathing B. Model slow paced breathing C. Monitor for Hypervent D. Conduct acupuncture E. Ask pt is it is OK to hold her hand
A, C, E
A woman with an epidural is 10 cm dilated and the baby is at 0 station. There is a reassuring fetal heart pattern, although the woman does not feel the urge to push. Which are appropriate actions by the nurse? **Select all A. Encourage the patient to wait to push until she feels the urge. B. Perform another vaginal examination to check for dilation. C. Encourage the patient to push so that the baby can be born. D. Encourage frequent position changes while remaining in the bed. E. Turn off the epidural so the patient can feel the urge to push.
A, D
Which education would the nurse provide a patient who is worried that the intrauterine catheter will hurt the baby? A. "The catheter is placed in the uterus next to the baby." B. "Don't be nervous; everything will be fine!" C. "The catheter attaches only to the outer layer of skin on the baby's head." D. "This is the equipment needed for high-risk pregnancies."
A. "The catheter is placed in the uterus next to the baby." By providing information about the safety and location of the catheter, the nurse can decrease the patient's anxiety and provide reassurance.
A G5/P4 is experiencing painful contractions that start in her back every 10 minutes for the last hour. How would the telephone triage nurse advise this woman? A. Advise the patient to report to the hospital for labor and delivery. B. Tell the patient to call an ambulance. C. Instruct the woman to come to the hospital when the contractions are every 5 minutes. D. Inform the patient that she is experiencing Braxton Hicks contractions.
A. Advise the patient to report to the hospital for labor and delivery. Multiparas should report to the hospital or birthing center with regular contractions for at least an hour that are 10 minutes apart.
Stages of labor
A. Cervical effacement and dilation from onset of true labor to complete dilation B. Complete cervical dilation and effacement to birth of baby C. Birth of baby to expulsion of placenta D. Expulsion of placenta to physical recovery of mom & infant
While evaluating an external monitor tracing of a woman who just received regional analgesia for pain management, the nurse notes recurrent late decelerations. Which action should the nurse take next? A. Change woman position B. Notify OB C. Assist w/ amnioinfusion D. Rupture the membranes and insert a scalp electrode.
A. Change the woman's position. Late decelerations may be caused by maternal supine hypotension syndrome. They may be corrected when the woman turns on her side to displace the weight of the gravid uterus from the vena cava.
Which fetal condition can cause a fetal heart rate (FHR) of <60 beats/min for more than 60 seconds that does not quickly return to baseline? A. Cord compression B. Fetal head compression C. Uteroplacental insufficiency D. no compromise
A. Cord compression Variable decelerations that last a long time and do not quickly return to baseline can occur with cord compression, which could compromise the fetus
Which method of anesthesia in labor is considered safest for infant? A. Local infiltration B. Epidural block C. Spinal Block D. CSE Block
A. Local Infiltration
Which assessment is most important to monitor after the administration of epidural anesthesia? A. Maternal BP B. Fetal BP C. Platelet count D. RR
A. Maternal BP
In the fourth stage of labor, the nurse monitors the hemodynamic stability of the postpartum patient through which assessment? A. Obtaining maternal VS every 15 minutes in first hour B. Assessing the couplet for bonding C. Obtaining maternal VS every 30 mins in first hour D. Assess color, amount, and order of urine after first void.
A. Obtaining maternal vital signs every 15 minutes in first hour
While awaiting the delivery of the placenta in the third stage of labor, the nurse observes a large gush of blood and an increase in the length of the umbilical cord. Which event would the nurse recognize has probably occurred? A. Placental separation from uterine wall B. Placental abruption C. Umbilical cord detachment from placenta D. Postpartum hemorrhage as a result of retained placenta
A. Placental separation from uterine wall
After assessment of an actively laboring woman, the nurse finds a fetal heart rate (FHR) of 180 beats/min with contractions occurring less than 2 minutes apart and lasting more than 90 seconds. Which action would the nurse take next? A. Reposition the patient to her side and alert the health care provider. B. Nothing, these are normal C. Prep for emergency c- section D. reposition patient
A. Reposition the patient to her side and alert the health care provider. The patient is experiencing tachysystole, fetal tachycardia, and incomplete uterine relaxation, which can lead to fetal compromise. Lateral positioning allows for optimal placental perfusion. The health care provider will need to evaluate this patient at the bedside.
Which observations suggest that a woman is the latent phase of the second stage of labor? **Select all A. The Fetus is at 0 station B. There is an irregular na inconsistent urge to bear down with contractions C. The woman exhibits loud, songlike vocalizations with every contraction D. The fetus is at +3 station. E. The woman sleeps between contractions. F. The woman is pushing involuntarily.
A. The fetus is at 0 station B. there is an irregular and inconsistent urge to bear down with contractions E. The woman sleeps between contractions.
Which statement regarding pain experienced during labor is accurate? A. The predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomen. B. Referred pain is extreme discomfort between contractions C. Somatic pain of second stage is more generalized and related to fatigue D. Pain during third stage is somewhat milder
A. The predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomen. This pain comes from cervical changes, distention of the lower uterine segment, and uterine ischemia.
How is effacement measured? **Select all** A. Through digital palpation by a trained professional B. Using transvaginal ultrasound C. By estimating the stage of labor D. Though palpation of cervical dilation E. Through Leopold maneuvers
A. Through digital palpation by a trained professional B. Using transvaginal ultrasound
Which passenger position would interfere with a safe vaginal birth? A. Transverse fetal lie B. Flexed fetal head C. Cephalic presentation D. Longitudinal fetal Lie
A. Transverse fetal lie
A nurse is caring for a patient in labor who is receiving oxytocin via intravenous infusion to stimulate uterine contractions. Which assessment finding would indicate to the nurse that the infusion needs to be discontinued? A. 3 contractions in 10 minutes B. FHR of 90 bpm C. Resting uterine tone of 15 mm Hg via intrauterine pressure catheter D. Early decelerations
A. fetal heart rate of 90 beats/min A normal fetal heart rate is 110 to 160 beats/min. Bradycardia and/or late or variable decelerations indicate fetal distress and the need to discontinue the oxytocin infusion.
A patient reports a feeling of lightness in her abdomen, increasing whitish, thin, and odorless vaginal discharge, and occasional contractions that go away after an hour or so. Which action would the nurse take next? A. Advise Pt. to birthing center B. Suggest routine STI C. Call ambulance because she is experiencing an emergency D. Educate patient on premonitory signs of labor
D. Educate the patient on the premonitory signs of labor. The nurse would educate the patient on premonitory signs of labor and counsel the patient that what she is experiencing is normal. The nurse would also educate on true versus false labor signs.
Which fetal heart rate finding may result from maternal fever? A. No change B. Prolonged decelerations C. FHR 90bpm for 15 min D. FHR 180 bpm for 12 min
D. FHR 180 bpm for 12 min A maternal fever can directly increase the fetal temperature or infect the fetus in cases of infection. The fetus responds with an increased heart rate, which can lead to fetal tachycardia.
A patient is experiencing intense back pain and discomfort during active labor. Which position would the nurse encourage the patient to assume? A. Standing straight B. Side-lying C. Semi-sitting D. Hands and Knees
D. Hands and Knees
Which uterine contraction strength classification is used when labor is measured at >500 Montevideo units (MVUs)? A. Normal B. Moderate C. Hypotonic D. Hypertonic
D. Hypertonic
Which patient would most likely require general anesthesia during labor and delivery? A. Patient with vaginal infection B. Patient with severe pain rom uterine contractions C. Patient requiring vaginal episiotomy D. Patient refusing regional and local anesthetic methods who needs a cesarean delivery
D. Patient refusing regional and local anesthetic methods who needs a cesarean delivery
Which action would the nurse take to improve placental blood flow immediately after administration of an epidural? A. Place woman flat on her back B. Place woman prone C. Place woman in high fowler D. Put wedge under woman hip
D. Place a wedge under the woman's right hip Placing a wedge under the right hip improves placental blood flow after a procedure that causes vasodilation
Which nonreassuring fetal heart rate (FHR) pattern includes a reduction in FHR of ≥15 beats/min for more than 2 minutes? A. Accelerations B. Tachycardia C. Early decel D. Prolonged decelerations
D. Prolonged decelerations Prolonged decelerations cause a decrease in FHR of ≥15 beats/min below baseline and last longer than 2 minutes but less than 10 minutes. The return to baseline FHR usually occurs after the contraction is over.
A patient experiences nausea and vomiting during labor. Which medication might the nurse anticipate administering? A. Fentanyl B. Naloxone C. Nalbuphine D. Promethazine
D. Promethazine because it alleviates nauseas and vomiting
A woman in labor is given an opioid analgesic for pain. Which vital sign is a priority for the nurse to monitor in the newborn infant? A. HR B. Temp C. BP D. Respiratory rate
D. RR since they can cause respiratory depression
A pregnant woman arrives at the emergency department, and after completing a vaginal examination the nurse midwife states that the patient is 5 cm dilated and 75% effaced and the fetus is at −3 station. Which statement is accurate regarding this assessment? A. The patient may initiate pushing efforts. B. The cervix is fully dilated. C. The cervix is fully effaced. D. The fetus is not engaged within the maternal pelvis
D. The fetus is not engaged within the maternal pelvis. Fetal engagement begins at 0 station.
Which situation demonstrates how an environmental factor could negatively affect a woman's experience of pain during labor? A. The woman experiencing tearing of the perineum during delivery B. The woman had a complicated delivery with her previous child C. The woman family views vocalizing about pain as complaining D. The woman has no support at her bedside
D. The woman has no support at her bedside
Which maternal or fetal condition might require an amnioinfusion? A. mother has polyhydramnios B. FHR is 140 bpm C. Patients BP has dropped D. Fetus experienced umbilical cord compression
D. he fetus has experienced umbilical cord compression.
Local Infiltration
least about of effects
Pudenal block
local anesthesia A/E: toxic rxn, rectal juncture, hematoma, sciatic nerve block
Spinal Block
when a quick cesarean block is necessary and no epidural - Woman loses sensory and motor function - Contraindicated in coagulation defects, uncorrected hypovolemia, infection in the area, related allergy, or fetal condition - A/E: HPN, bladder distention, spinal headache
Which qualities are considered normal when assessing fetal heart rate (FHR)? **Select all A. FHR variability of <5 bpm B. Baseline FHR of 140/min C. FHR variability of 20 bpm D. Baseline FHR of 100 bpm E. Baseline FHR of 170 bpm
B, C
A nurse is beginning to care for a patient in labor. The health care provider has prescribed an intravenous (IV) infusion of oxytocin. The nurse makes sure that which implementations occur before initiation of the infusion? **Select all A. Placing patient on bedrest B. Continuous EFM C. IV infusion of ATB D. making sure vial of terbutaline is immediately available E. Prep infusion pump F. Code cart at patients bedside
B, D, E
Which assessment findings in the laboring patient would suggest to the nurse that delivery is imminent? **Select all A. Woman can talk through contractions B. Contractions are 1.5 to 2 mins apart C. Regular contractions are mild and 7 mins apart D. Mucous vaginal discharge is bloody E. Woman is experiencing N/V, sweating F. Patient complains of rectal pleasure
B, D, E, F
The nurse is instructing a childbirth class on abdominal breathing and tells a patient that her baseline respiratory rate is 22 breaths/min. What should the patient's rate be while performing slow-paced breathing techniques? A. 9/min B. 11/min C. 15/min D. 20/min
B. 11/min
What would the nurse expect when caring for a full-term primigravida who presents for a routine office visit and is not in labor? A. A fundal height that measures 30 cm B. A fetus that is engaged in the maternal pelvis C. A cervix that is already 3 cm dilated D. Fetal station of −3
B. A fetus that is engaged in the maternal pelvis
A postpartum patient who had a spinal block for a scheduled cesarean delivery complains of a headache. Which intervention would the nurse anticipate? A. PO admin of promethazine B. Administration of blood patch by the anesthesia provider C. Having patient sit up in chair to help reliever headache D. Allow spinal headache to run its course
B. Administration of blood patch by the anesthesia provider Administration of a blood patch by an anesthesia professional is a procedure in which the patient's blood is injected into the spinal space, creating a seal over the site where the dural puncture occurred.
A woman is 10 cm dilated and feels occasional rectal pressure at the peak of a contraction, and the fetal station is 0. There is a reassuring fetal heart tracing. Which nursing action is appropriate at this time? A. Recheck the cervical dilation to ensure she is 10 cm. B. Allow the woman to labor down for passive descent C. Encourage the woman to push with every contraction D. Prepare for cesarean delivery for cephalopelvic disproportion
B. Allow the woman to labor down for passive descent The Latent Phase may also be referred to as laboring down, delayed pushing, or passive descent.
A woman at 37 weeks gestation calls and reports, "My water broke and I have bloody show. I am changing my pad every 10 minutes." Which advice would the nurse provide in response? A. Engage in activities, such as walking B. Call her health care provider and go to the hospital or birthing center C. Advise woman that overreacting not good for her or the baby and to call back when she is in true labor. D. Remain home and only come to the hospital in contractions are regular, frequency, and intense
B. Call her healthcare provider and go to hospital or birthing center for vaginal evaluation.
A G2/P1 woman presents for evaluation. She is excited, can talk through regular contractions every 7 to 10 minutes, and states that her pain is "manageable." She does not desire epidural anesthesia in labor. The nurse suspects this patient is in which phase of labor? A. Transitional labor B. Early labor C. Second stage of labor D. Active labor
B. Early Labor
A patient in labor experiences minimal relief after nonpharmacologic interventions, and she is not coping well in labor. Which action would the nurse take next? A. Suggest epidural B. Educate on risks and benefits of pharmacologic intervention C. Encourage the patient to ambulate in the room D. Administer prescribed dose of IV pain meds
B. Educate on the risks and benefits of pharmacologic interventions. By providing the patient with education and options, the nurse empowers her to make decisions about her body and labor and delivery experience.
Which solution can the nurse consider to encourage a positive birth experience for the patient and her support person following delivery? A. Offer to take the baby to the nursery to promote rest for the patient and the support person. B. Encourage the family to talk about the labor and delivery experience. C. Immediately after birth, remove amniotic fluid and vernix from the baby before placing it skin-to-skin with the mother. D. Provide all infants with pacifiers to promote infant and family rest.
B. Encourage the family to talk about the labor and delivery experience.
The nurse midwife writes in the progress note that the baby is in the occiput posterior presentation. The nurse knows that which maternal position will help facilitate rotation of the fetal head? A. Side Lying B. Hands and Knees C. Semi-Recumbent D. Lithotomy
B. Hands and Knees This position pulls the fetus back forward and allows for better rotation of the fetal head
.During the fourth stage of labor, the nurse notes an increased amount of bleeding. The uterine fundus consistency is boggy. Which is the most appropriate initial nursing action? A. Alert the health care provider that the patient is experiencing postpartum hemorrhage. B. Massage the uterine fundus and observe for change in consistency. C. Administer uterotonic medications to increase uterine tone. D. Do nothing, as this is a normal finding in the fourth stage of labor and the tone is transient.
B. Massage the uterine funds and observe for change in consistency
A woman received 25 mg of meperidine intravenously 1 hour before delivery. Which drug would the nurse have readily available? A. Ibuprofen B. Naloxone C. Nalbuphine D. Pitocin
B. Naloxone Naloxone is the antagonist for opioid medications and should be available for administration to the neonate who exhibits signs of respiratory depression after birth.
Occiput posterior refers to which component of the birth process? A. Powers B. Passenger C. Passage D. Psyche
B. Passenger
A woman is experiencing strong contractions every 1.5 to 2 minutes, feels rectal pressure, and has a large amount of bloody show. At which frequency would the nurse anticipate assessing the fetal heart rate and pattern? A. 30 - 45 mins B. 5 - 10 mins C. 15 - 30 mins D. 45 - 60 mins
C
A patient is concerned about the baseline variability in the heart rate of her fetus. Which responses by the nurse describe the significance of baseline variability to the patient? **Select all A. Variability is an artifact B. Variability is a periodic pattern C. Variability demonstrates that there is adequate oxygenation of the fetus D. Variability suggest that the fetus is able to adapt to the labor process E. Variability indicates that the fetus has no congenital abnormalities
C, D
Which clinical conditions must be met before placing a fetal scalp monitor? **Select all A. Patient should not be in labor B. Absence of fetal scalp hair C. Cervix should be at least 2 cm dilated D. Patients membranes must be ruptured E. High fetal presentation
C, D
Which uterine activity indicators does the intrauterine pressure catheter (IUPC) measure in mm HG? **Select all A. Frequency B. Duration C. Intensity D. Resting tone E. Variability
C, D
The labor nurse is evaluating the patient's most recent 10-minute segment on the monitor strip and notes a late deceleration. Which explanations most likely explains this occurrence? ***Select all A. Sponataneous fetal movement B. Compression of fetal head C. Placental abruption D. Nuchal cord around baby neck E. Vena Cava syndrome
C, E
The nurse knows that patient education has been effective when the patient makes which statement about the difference between a tocodynamometer and an intrauterine pressure catheter (IUPC)? A. "Only the tocodynamometer shows my uterine activity." B. "The tocodynamometer is much more accurate than the IUPC." C. "The tocodynamometer is positioned outside my body, while the IUPC is positioned inside my body." D. "The tocodynamometer will be connected to my bedside monitor, but the IUPC will not."
C. "The tocodynamometer is positioned outside my body, while the IUPC is positioned inside my body."
Which response would the nurse provide the patient who asks why oxygen is being given after the nurse identifies a nonreassuring fetal heart rate? A. "I will call the health care provider to discuss the new care plan." B. "We need to increase the perfusion of the baby's placenta." C. "We need to increase your oxygen, which will increase the baby's oxygen." D. "Don't worry. This happens all of the time, and everything is fine."
C. "We need to increase your oxygen, which will increase the baby's oxygen."
Which deceleration is considered a normal finding? A. Variable B. Prolonged C. Early D. Late
C. Early
A laboring woman wishes to labor in the shower to alleviate pain. Which nonpharmacologic pain relief method is she applying? A. Massage B. Acupuncture C. Hydrotherapy D. Relaxation
C. Hydrotherapy
The nurse notes fetal tachycardia and suspects that the patient may be dehydrated. Which nursing action is appropriate to address this nonreassuring finding? A. Consult with dietician B. Administer parenteral feeding C. Increase rate of IV saline D. Provide PO electrolytes
C. Increase rte of IV saline
A patient arrives at a birthing center in active labor. Her membranes are still intact, and the health care provider prepares to perform an artificial rupture of membranes (AROM). What will the nurse relay to the patient as the most likely outcome of the procedure? A. Less pressure on cervix B. Decreased number of contractions C. Increased pressure on Cervix D. Need for more cervical exams
C. Increased pressure on Cervix
The nurse recognizes that the patient understands the teaching when she makes which statement? A. "Premonitory labor signs include rupture of membranes." B. "I will know I'm in labor when I lose my mucous plug." C. "Increasing clear vaginal secretions could mean labor will begin soon." D. "Bright red bleeding is considered bloody show and means labor will begin soon."
C. Increasing clear vaginal secretions could mean labor will begin soon
Which statement does the nurse use to describe to the patient's partner why opioid analgesics are being administered? A. Opioid analgesics prevent nausea B. Opioid analgesics remove pain of labor C. Opioid analgesics help laboring woman relax between contractions D. Opioid analgesics reduce Resp Dep for the laboring woman
C. Opioid analgesics help the laboring woman relax between contractions
The nurse receives reports on two women in early labor, a nulliparous woman and a multiparous woman. Both are 3 cm dilated. Which statement is true regarding who will enter active labor first? A. The multiparous woman will enter active labor first. B. The nulliparous woman will enter active labor first. C. They will both progress at similar rates. D. The patient whose contractions palpate stronger will enter active labor first.
C. They will both progress at similar rates.
For which reason would a nurse administer a narcotic to a woman at the beginning of a contraction? A. To allow the medication to be transferred to both the laboring woman and the fetus B. To allow for no medication to be transferred to the fetus C. To allow for less medication to be transferred to the fetus D. To decrease the likelihood of maternal hypotension
C. To allow for less medication to be transferred to the fetus
The nurse caring for the woman in labor recognizes that maternal hypotension puts the laboring woman at risk for which result? A. Early decelerations B. Fetal dysrhythmias C. Uteroplacental insufficiency D. Spontaneous rupture of membranes
C. Uteroplacental insufficiency Low maternal blood pressure reduces placental blood flow during uterine contractions and results in fetal hypoxemia. This hypoxemia can lead to late decelerations in the fetal heart rate.
Which action taken by the patient will reduce discomfort during Leopold maneuvers and make fetal presenting parts easier to feel? A. Standing B. Lying Prone C. Emptying the bladder D. Pushing or bearing down with contractions
C. emptying the bladder
A woman who is at 38 weeks gestation reports suspected signs of labor to the triage nurse. Which statement by the nurse supports the beginning of true labor? A. "Your contractions will decrease with activity." B. "The contractions will be mild and more annoying than painful." C. "You will feel the contractions in your front pelvic area and not in your back." D. "Labor contractions will occur in a consistent pattern that increases in frequency, duration, and intensity."
D. "Labor contractions will occur in a consistent pattern that increases in frequency, duration, and intensity."
Maternity nurses often have to answer questions about the many, sometimes unusual, ways people have tried to make the birthing experience more comfortable. Which information would the nurse consider when educating patients and support people about nonpharmacologic pain management techniques? A. Music supplied by the support person has to be discouraged because it could disturb others or upset the hospital routine. B. Women in labor can benefit from sitting in a bathtub, but they must limit immersion to no longer than 15 minutes at a time. C. Effleurage is permissible, but counterpressure is almost always counterproductive. D. Acupressure to either side of the spine can facilitate the release of endorphins and decrease some back pain.
D. Acupressure to either side of the spine can facilitate the release of endorphins and decrease some back pain.
