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Contraction cause constriction of blood to the

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Contraction cause constriction of blood to the placenta, decreasing fetal oxygen supply(155)True labor: Cervical changes show progressive dilation and effacement (157)False labor: Walking decrease the frequency or eliminates the contractions altogether(157)Factors affect maternal psyche (Box 8-2; 158)Culture influence: Acceptable responses to pain during laborCurrent Pregnancy experience: Amount of difficulty conceivingCulture influences: Shameful vs JoyfulPresence & Support of birth companionCardinal movement (158-159)Engagement (initial descent): Presenting part descends to the level of ischialspinesExtension: Fetal head is well flexed with chin on the chest, reaches pubic archLabor Phase (160) Table 8-3 page 161Active Phase: Cervix dilate from 4-8 cm & contractions are 2-5 minutes apartlasting 45-60 secondsSecond stage (birth): Maternal response of feeling of begging in control & lessirritableThird stage: Ends with th delivery of placentaAverage length of second stage for primparas: 1 hours (160)Indicate the placenta separating from the uterine wall (160)Lengthening of the umbilical cordGush of bloodCephalohematoma: Collection of blood under the newborn scalp (163)Chapter 9General concepts related to pain: Threshold & Tolerance (168)Physiologic factors that are directly related to the birthing process, affect the perceptionof pain (168)Mom reports more pain when experiencing abnormal laborThe longer the labor, mom more likely to report extreme painMom injected with oxytocin report extremely strong, intense contractionsMom with back labor report intense discomfort (back breaking in two)Example of non pharmacological comfort measures for a laboring mother (169)Change liens that are solid with perspiration or body fluidsGive perineal care with warm water after mom uses the restroomKeep lips hydrated with ice chips and lip balmHydrotherapy: Exposure of water for the mom, either show, bath or whirlpool to increasecomfort (171)Patterned breathing technique, take slow deliberated breaths while focusing, approx. 6-10 breaths per minute (Table 9-2; 171)Slow-paced breathingIntradermal injection of sterile water can effectively relieve the pain of back labor (172)
Anesthesia: Use of of medication to partially or totally block all sensation to an area ofthe body (173)Analgesia: Use of medication to reduce sensation of painSedatives can produce neonatal respiratory depression if given 12-24 hours of birth(Table 9-3; 174)Receiving an epidural before 5 cm dilation can increase the need for labor augmentationwith oxytocin (Table 9-3; 174)Barbiturates can cause respiratory & CNS depression in the newborn if given within 12-24 hours of birth (175)Interventions prior to a client can get an epidural (176)Informed consent is required500-20000 mL IV fluid bolus is given to reduce the risk of hypotensionIV line must be in placeSide effects when narcotics are used with anesthetics (Table 9-3; 174)PruritusDisadvantages of epidural (Table 9-3; 175 & 176)Increase need of labor augmentation if administered before 5 cm dilationImpairs motor function, which decrease the ability to walk during laborVacuum assistance and forceps are more frequently requiredSpinal HA is suspected when the lady has an intense HA in the upright position, relievedwhen lies down and is still (177)FALSE (176)After delivery appropriate interventions that are done for client with epidural (176)

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Term
Fall
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The Land, Oxytocin

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