Maternity Exam #2 Study Guide Graded A 2023

Nursing Management for the Laboring Patient: Types of Pain: ● Visceral Pain: Located over lower portion of the abdomen and radiates to the lumbar area of the back and down the thighs due to contractions ● Somatic pain: Perineal pain (Expulsion of the baby) ● Referred pain: Felt in back, flanks, or thighs Factors affecting pain: ● Perception: Depends on culture, coping skills, support system ● Anxiety, fear, sleep deprivation, fatigue can magnify pain (also substance abuse) Gate Control Theory of Pain: Pain sensations travel along sensory nerve pathways to the brain ● Purpose: Use of techniques that reduce or block the nerve pathway ● Gate Control Interventions: ○ Cognitive strategies: Childbirth education (Lamaze), hypnosis ○ Sensory stimulation strategies: Breathing techniques, music, and focal points, aromatherapy, dimmed lighting ○ Cutaneous stimulation strategies: Therapeutic touch, massage, back rubs, effleurage, sacral counter pressure Nonpharmacological Management of Discomfort: ● Dick Read Method: Technique of delivery called natural childbirth. Limited anesthetics. Concentration on the mother’s conscious effort to give birth to her child. ● Lamaze Method: Laboring women are encouraged to move around and follow their body’s urges to push. Method stresses breathing patterns and other natural relaxation techniques for dealing with pain. ● Bradley Method: Classes are small and cover nutrition, relaxation techniques for labor and birth, breastfeeding and more. ● Therapeutic touch, massage, and aromatherapy ● Frequent maternal position changes are necessary to relieve fatigue, increase comfort, and to improve circulation. ● During the second stage: Kneeling and squatting are most effective to increase the pelvic outlet. ● Jet hydrotherapy/showers ● Hypnosis, yoga, acupressure. Regional Anesthesia: Epidural/Spinal ● Advantages: Pain free labor and preserves maternal energy ● Disadvantages: Induces major hypotension; Cannot feel contractions