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![Page 1: Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Chapter 7 Nursing Management of Pain During Labor and Birth.](https://reader035.fdocuments.net/reader035/viewer/2022062407/56649dcf5503460f94ac3d1d/html5/thumbnails/1.jpg)
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Chapter 7Chapter 7
Nursing Management of Pain During Labor and Birth
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2Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
ObjectivesObjectives
Define each key term listed. Describe factors that influence a woman’s
comfort during labor. List the common types of classes offered to
childbearing families. Describe the methods of childbirth
preparation.
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3Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Objectives (continued)Objectives (continued)
Discuss the advantages and limitations of nonpharmacological methods of pain management during labor.
Discuss the advantages and limitations of pharmacological methods of pain management.
Explain nonpharmacological methods of pain management for labor, including the nursing role for each.
Explain each type of pharmacological pain management including the nursing role for each.
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4Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Education for ChildbearingEducation for Childbearing
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5Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Types of Classes AvailableTypes of Classes Available
Gestational diabetes mellitus Early pregnancy Exercise for pregnant women Infant care Breastfeeding Sibling Grandparent Adolescent childbirth
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6Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Variations of Basic Childbirth Preparation Classes
Variations of Basic Childbirth Preparation Classes
Refresher Cesarean birth Vaginal birth after cesarean
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7Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Content of Childbirth Preparation ClassesContent of Childbirth Preparation Classes
Benefits of exercise Pain control methods for labor
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8Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Childbirth and PainChildbirth and Pain
How childbirth pain differs from other pain Part of a normal birth process Woman has several months to prepare for pain
management Is self-limiting and rapidly declines after birth
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9Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Factors that Influence Labor Pain
Factors that Influence Labor Pain
Pain threshold Sources of pain during labor Central nervous systems factors
Gate control theory Endorphins
Maternal conditions Cervical readiness Pelvis Labor intensity Fatigue
Fetal presentation and position
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10Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Nonpharmacological Pain Management
Nonpharmacological Pain Management
Advantages of nonpharmacological methods
Limitations of nonpharmacological methods
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11Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Methods of Childbirth Preparation
Methods of Childbirth Preparation
Dick-Read method Bradley method Lamaze method
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12Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Selected Nonpharmacological Pain Relief Measures
Selected Nonpharmacological Pain Relief Measures
Progressive relaxation
Neuromuscular dissociation
Touch relaxation Relaxation against
pain Effleurage
Sacral pressure Thermal stimulation Positioning Diversion and
distraction Hydrotherapy
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13Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Nonpharmacological Techniques
Nonpharmacological Techniques
Relaxation techniques
Skin stimulation Effleurage Sacral pressure Thermal stimulation Positioning The nurse’s role
Diversion and distraction
Focal point Imagery Music Television
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14Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Skin StimulationSkin Stimulation
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15Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
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BreathingBreathing
First stage Slow paced Modified paced Patterned paced
Second stage
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Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
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17Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
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How to Recognize and Correct Hyperventilation
How to Recognize and Correct Hyperventilation
Signs and symptoms Dizziness Tingling of hands and
feet Cramps and muscle
spasms of hands Numbness around
nose and mouth Blurring of vision
Corrective measures Breathe slowly, especially
when exhaling Breathe into cupped
hands Place a moist washcloth
over the mouth and nose while breathing
Hold breath for a few seconds before exhaling
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18Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
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Nursing TipNursing Tip
If a woman is successfully using a safe, nonpharmacological pain control technique, do not interferedo not interfere
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19Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Pharmacological Pain Management
Pharmacological Pain Management
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20Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Physiology of Pregnancy & its Relationship to Analgesia & Anesthesia
Physiology of Pregnancy & its Relationship to Analgesia & Anesthesia
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Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Pharmacological MethodsPharmacological Methods
Advantages
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Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Pharmacological Methods Pharmacological Methods
Limitations
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23Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Analgesics and Adjunctive DrugsAnalgesics and Adjunctive Drugs
Narcotic (opioid) analgesics Narcotic antagonist Adjunctive drugs
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24Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Regional Analgesics and Anesthetics
Regional Analgesics and Anesthetics
The meninges around the spinal cord Dura mater Arachnoid mater Pia mater
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25Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Types of Anesthesia for Childbirth
Types of Anesthesia for Childbirth
Anesthetic method Local infiltration Pudendal block Epidural block Subarachnoid (spinal) block General anesthesia
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Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc. 26
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27Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
Epidural Blood PatchEpidural Blood Patch
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28Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
Inc.
General AnesthesiaGeneral Anesthesia
Adverse effects in the mother Adverse effects in the neonate
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29Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
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Question for ReviewQuestion for Review
What is the most important nursing responsibility after an epidural or spinal block analgesia during labor and delivery?
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30Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier
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ReviewReview
Objectives Key Terms Key Points Online Resources Critical Thinking Questions Review Questions