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