Term
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Definition
| Visceral pain is pain that results from the activation of nociceptors of the thoracic, pelvic, or abdominal viscera (organs). Visceral structures are highly sensitive to distension (stretch), ischemia and inflammation, but relatively insensitive to other stimuli that normally evoke pain such as cutting or burning. |
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Term
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Definition
| Somatic pain is a type of nociceptive pain that is also referred to as skin pain, tissue pain, or muscle pain. Unlike visceral pain (another type of nociceptive pain that arises from internal organs), the nerves that detect somatic pain are located in the skin and deep tissues.Jun 26, 2017 |
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| Cultural responses to pain |
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Definition
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Term
| What is the gate control theory of pain? |
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Definition
| According to this theory, pain sensations travel along sensory nerve pathways to the brain but only a limited number of sensations, or messages, can travel through these nerve pathways at one time. Using distraction techniques such as massage or stroking, music, focal points, and imagery blocks the capacity of nerve pathways to transmit pain. These distractions work by closing down a hypothetical gate in the spinal cord, thus preventing pain signals from reaching the brain. |
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Term
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Definition
| light stroking, usually of the abdomen, in rhythm with breathing during contractions. It is used to distract the woman from contraction pain. Often the presence of monitor belts makes it difficult to perform effleurage on the abdomen; therefore a thigh or the chest may be used. As labor progresses, hyperesthesia (hypersensitivity to touch)may make effleurage uncomfortable and thus less effective. |
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Term
| What is an undesirable reaction to patterned-paced breathing? |
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Definition
| Hyperventilation. Symptoms of the resultant respiratory alkalosis: Lightheadedness, dizziness, tingling of the fingers, or circumoral numbness. Respiratory alkalosis may be eliminated by having the woman breathe into a paper bag held tightly around her mouth and nose. This enables her to rebreathe carbon dioxide and replace the bicarbonate ions. The woman also can breathe into her cupped hands if no bag is available. |
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Term
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Definition
| steady pressure applied by a support person to the sacral area with a firm object. Counterpressure helps the woman cope with the sensations of internal pressure and pain in the lower back. It is especially helpful when back pain is caused by pressure of the occiput against spinal nerves when the fetal head is in a posterior position. Counterpressure lifts the occiput off these nerves, thereby providing pain relief. |
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Term
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Definition
| encompasses analgesia, amnesia, relaxation, and reflex activity. Anesthesia abolishes pain perception by interrupting the nerve impulses to the brain. The loss of sensation may be partial or complete, sometimes with the loss of consciousness. |
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Term
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Definition
| refers to the alleviation of the sensation of pain or the raising of the threshold for pain perception without loss of consciousness. The type of analgesic or anesthetic chosen is determined in part by the stage of labor of the woman and by the method of birth planned. |
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Term
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Definition
| Sedatives relieve anxiety and induce sleep. They may be given to a woman experiencing a prolonged latent phase of labor when there is a need to decrease anxiety or promote sleep. They may also be given to augment analgesics and reduce nausea when an opioid is used. |
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Term
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Definition
| Should be avoided if birth is anticipated within 12-24 hours due to potential for neonatal CNS depression. Depressant effects are increased with other CNS depressants such as opioid analgesics. Pain will be magnified if a barbiturate is given without an analgesic to a woman in pain because her normal coping mechanisms can be blunted. |
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Term
| Effects of phenothiazines |
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Definition
Do not relieve pain. In the past, promethazine was often given with opioids to enhance the analgesic effects of opioids, decrease anxiety and apprehension, increase sedation, and reduce nausea and vomiting. However, research has shown that promethazine actually impairs the analgesic efficacy of opioids.
Metoclopramide (Reglan), an antiemetic, has been found to effectively potentiate the effects of analgesics. Therefore its use is recommended, rather than promethazine. |
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Term
| Effects of benzodiazepines |
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Definition
Benzodiazepines (diazepam [Valium], lorazepam [Ativan]), when given with an opioid analgesic, seem to enhance pain relief and reduce nausea and vomiting. A major side effect is significant maternal amnesia. A major disadvantage of diazepam is that it disrupts thermoregulation in newborns, making them less able to maintain body
temperature. Flumazenil (Romazicon) is a specific benzodiazepine antagonist, which can
effectively reverse benzodiazepine-induced sedation and respiratory depression. |
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Term
| Advantages of PCA during labor |
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Definition
| With PCA, the woman self-administers small doses of an opioid analgesic by using a pump programmed for dose and frequency. Overall, a lower total amount of analgesic is used. Women appreciate the sense of autonomy provided by this method of pain relief, as well as the elimination of treatment delays while the patient’s nurse obtains and administers the medication. |
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Term
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Definition
| Provide sedation and euphoria, but analgesic effect in labor is limited. Pain relief is incomplete, temporary, and more effective in early part of active labor. side effects are respiratory depression, sedation, nausea, vomiting, dizziness, altered mental status, euphoria, decreased gastric motility, delayed gastric emptying, and urinary retention. Cross placenta. Decrease maternal HR, RR and BP, which affects fetal oxygenation. Therefore maternal vital signs and FHR and pattern must be assessed and documented before and after administration of opioids for pain relief. |
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Term
| Effects of opioid agonists |
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Definition
Meperidine (Demerol) and fentanyl
(Sublimaze). They have no amnesic effect but create a feeling of well-being or euphoria and enhance a woman’s ability to rest between contractions. Because opioids can inhibit uterine contractions, they should not be administered until labor is well established unless they are being used to enhance therapeutic rest during a prolonged latent phase of labor. |
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Term
| Effects of opioid agonist-antagonists |
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Definition
| Major advantage is their ceiling effect for respiratory depression. Less likely to cause nausea and vomiting, but sedation may be as great or greater when compared with pure opioid agonists. As a result of these effects, parenteral opioid agonist antagonist analgesics are used more commonly during labor than the opioid agonist analgesics. This class of opioids, especially nalbuphine, is not suitable for women with an opioid dependence, because the antagonist activity could precipitate withdrawal symptoms (abstinence syndrome) in both the mother and her newborn. |
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Term
| Effects of opioid antagonists |
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Definition
| An opioid antagonist (naloxone [Narcan]) is contraindicated for opioid dependent women because it may precipitate abstinence syndrome (withdrawal symptoms). For the same reason, opioid agonist-antagonist analgesics such as butorphanol (Stadol) and nalbuphine (Nubain) should not be given to opioid-dependent women. |
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Term
| what is Local Perineal Infiltration Anesthesia |
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Definition
| May be used when an episiotomy is to be performed or when lacerations must be sutured after birth in a woman who does not have regional anesthesia. Epinephrine often is added to the solution to localize and intensify the effect of the anesthesia in a region and to prevent excessive bleeding and systemic absorption by constricting local blood vessels. |
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Term
| what is pudendal nerve block |
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Definition
Administered late in the second stage of labor, is useful for episiotomy, use of forceps or a vacuum extractor. Also used in the third stage of labor for episiotomy or if lacerations must be repaired. Considered to be reasonably effective, simple to perform, and very safe. Does not relieve pain from uterine contractions but relieves pain in the lower vagina, the vulva, and the perineum. Should be administered 10 to 20 minutes before perineal anesthesia is needed. Does not change maternal hemodynamic or respiratory functions, vital signs, or the FHR. However, the bearingdown reflex is lessened or lost completely.
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