OB ch. 19 Exam 2
Local infiltration
Local anesthesia injected into perineum prior to episiotomy
What must the vital signs look like to administer systemic drugs?
stable
Prior to administering prescribed medications what should the nurse assess?
the mother and fetus along with contraction patterns
What should the nurse assess on epidural patient?
the need for urinary catheterization (if bladder sensation lost), assess motor control and orthostatic blood pressure
A G1P0 client's cervix is 4 cm dilated. She tells the nurse, "I'm in pain, but I'm afraid that medication might harm my baby." Which response is the most therapeutic regarding pain medication during labor?
"Pain medications do affect the baby, but so do pain and stress."
Immediately after a cesarean section birth, the anesthesiologist plans to inject a narcotic into the epidural space to provide analgesia for approximately 24 hours. Which opioid should the nurse anticipate that the physician would use?
Duramorph
What may drugs cause for the baby if given too late in labor?
Fetal respiratory depression
The nurse is caring for a laboring client who just received an epidural block. What is the major adverse effect for which the nurse should observe?
Hypotension
A laboring client has received an order for epidural anesthesia. In order to prevent the most common complication associated with this procedure, the nurse would expect to?
Rapidly infuse 500 to 1000 mL of intravenous fluids
Nursing care to general anesthesia
assess mothers intake, administer prescribed meds, place wedge under mothers right hip, provide oxygen prior to surgery, ensure IV access established, and assist anesthesiologist
Major complications for general anesthesia in a pregnant woman
fetal depression, uterine relaxation, vomiting, aspiration
Pudendal block possible side effects
hematoma, perforation of rectum, trauma to sciatic nerve
How is the spinal block administer different for different forms of delivery?
higher for cesarean and lower for vaginal birth
Most common side effect of epidural
hypotension
How quickly does a spinal block onset once administered?
immediate
Epidural injection
injection of anesthetic agent into epidural space
What does a local infiltration require?
large amounts of local anesthetic agents
Pudendal block
local anesthesia injected directly into pudendal nerve, which produces anesthesia to lower vagina, vulva, perineum
Spinal block
local anesthetic agent injected directly into spinal canal
Spinal block side effects
maternal hypotension, indwelling catheter, decreased led movement for 8 to 12 hours after birth
What is pudendal effect on fetus or process of labor?
none
Pudendal pain relief
only produces pain relief at the end of labor
What does local infiltration provide?
pain relief only for episiotomy incision
What does epidural do?
produce little or no feeling to area from uterus downward
Goal of pharmacological relief
provide maximum pain relief with minimum harm to mother and fetus
What might the epidural impair?
pushing during the second stage of labor