NURS256 Pain Concept Map by https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv en-us 2022-05-02 16:46:59 UTC 2022-05-02 18:03:16 UTC hello@padlet.com Deficient knowledge https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167086674 2022-05-02 16:58:48 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167086674 Patient History https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167090982 - Primipara @ 41.2 weeks gestation
- Afraid of "how bad the pain will get"

]]> 2022-05-02 17:01:41 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167090982 Birth-Plan https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167092873 - Pain management with epidural once 5cm dilated
- Labor induction with Pitocin; increase every 30 minutes for strong UC every 2-3 minutes
- Foley balloon is inserted for cervical ripening]]> 2022-05-02 17:03:06 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167092873 Behavior/psychosocial https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167095465 - She is afraid of how bad the pain will get.
- Anxiety]]> 2022-05-02 17:04:54 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167095465 Acute pain https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167098363 2022-05-02 17:06:40 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167098363 Non-Pharmacological Pain Management maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167100736 - Continuous labor support
- Hydrotherapy
- Ambulation and position changes
- Acupuncture, acupressure
- Application of heat and cold
- Attention focusing and imagery
- Breathing techniques]]> 2022-05-02 17:08:22 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167100736 Epidural Anesthesia https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167102952 2022-05-02 17:09:44 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167102952 Pain Medications madelinethackeray https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167104570 Vistaril 50-100 mg orally
Morphine 10 mg IM
Fentanyl 50-100 mg IV]]> 2022-05-02 17:10:51 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167104570 Advantages and Limitations madelinethackeray https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167107150 Advantages:
-Takes the edge off
-Allows the patient to relax/rest 
-Allows time for coping education

Limitations:
-Side effects like nausea
-Doesn’t work as well after 2 doses
-Can’t give close to delivery
]]> 2022-05-02 17:12:27 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167107150 Risks and Benefits maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167108857 Non-pharmacological measures are inexpensive, simple, and safe alternatives before depending on medications for pain relief.

These methods provide a gate control theory of pain, in which other forms of bodily stimulation interfere with transmission of pain stimuli from the spinal cord reaching the brain. 

Although not all of these methods may completely eradicate the sense of pain, and are mostly effective for mild-moderate pain, they at least allow the patient to sense feelings of control, especially during labor contractions.]]> 2022-05-02 17:13:33 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167108857 Ambulation and Position Changes maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167112818 Frequent position changes help change the position and shape of the pelvic joints, assisting the fetus to shift around through the birth canal. Other positions allow for better rest, can have the same benefits as ambulating, provide rhythmic movements to provide relaxation and comfort, and utilize gravity to help the fetus descend towards the pelvic outlet. ]]> 2022-05-02 17:16:13 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167112818 Epidural Benefits and Risks https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167115983 Benefits: 
- Allows the patient rest
- Improves coping and ability to follow directions
- More enjoyable birth experience
- Can allow for labor progress
Risks:
- Can be one-sided
- Can slow labor
- Can make pushing more difficult
- Spinal headache, back sorness]]> 2022-05-02 17:18:12 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167115983 Epidural-Nursing Intervention & Considerations https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167119384 - Can cause hypotension
- Frequent BP checks
- Frequent position changes
- Dermatome checks
- Urinary catheter
- Limit food, fluids to prevent aspiration
- Coaching for pushing]]> 2022-05-02 17:20:29 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167119384 Continuous Labor Support maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167124679 The patient and family will need constant emotional, physical, and informational support, considering childbirth being a life-changing experience. This may include helping formulate a birth plan, or providing words of affirmation. It is best to provide a high-touch, low-tech approach in nursing, so patients can sense a true therapeutic connection with their nurse, and feel that they really care to help them obtain optimal health.]]> 2022-05-02 17:24:14 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167124679 What Influences Pain During Labor (Physiological Factors) https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167125137 - Cervical Stretching 
- Hypoxia of the uterine muscle d/t dec. perfusion during contraction 
- Pressure in the urethra, bladder, and rectum 
- Distention of the muscle of the pelvic floor


]]> 2022-05-02 17:24:37 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167125137 Hydrotherapy maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167127226 This is the external use of water to promote health and body relaxation. When soaking in a regular tub or whirlpool, the warm shower releases muscle tension, promotes vasodilation, and a reduction of catecholamines; however, be sure the temperature does not exceed that of the mother's body temperature, and monitor for s/s hypo-/hyperthermia.]]> 2022-05-02 17:25:58 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167127226 Acupuncture, Acupressure maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167129764 These require the skills of a trained, certified clinician, in which key trigger points of the body are slightly penetrated with needles, or the pressure of one's fingers, trying to regulate a flow of energy through all the body systems. This also releases endorphins to reduce the perception of pain.]]> 2022-05-02 17:27:49 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167129764 Inhaled Analgesics https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167132457 Nitrous oxide (50%) + Oxygen (50%)]]> 2022-05-02 17:29:47 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167132457 Application of Heat and Cold maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167136196 Use of heat can minimize chills or trembling, joint stiffness, muscle spasms, and promote connective tissue extensibility. Cold therapy relieves muscle spasms and reduces inflammation or edema, but keep in mind that the use of cold therapy is not sufficient enough to reduce labor pain. Maintain safety precautions of having a cover on the heat/cold source, to prevent direct contact causing things like skin burns.]]> 2022-05-02 17:32:29 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167136196 Nitrous Oxide Gas Benefits & Risks https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167138000 Benefits:
- Self-administered
- Safety mechanism: impossible to overdose
Potential side effects:
- N&V
- dizziness and dysphoria (rare)

]]> 2022-05-02 17:33:49 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167138000 What Influences Pain During Labor (Psychological Factors) https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167138888 - Pervious experience with pain 
- Fatigue 
- Pain anticipation 
- Genetics 
- Positive or negative support system 
- HCP's presence & encouragement 
- Labor & birth environment 
- Cultural expectations 
- Level of emotional stress & anxiety ]]> 2022-05-02 17:34:29 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167138888 Risks madelinethackeray https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167140055 Morphine: 
-maternal/fetal CNS depression 
-decreased uterine contractions

Fentanyl: 
-maternal hypotension
-maternal/fetal respiratory depression]]> 2022-05-02 17:35:19 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167140055 Attention Focusing and Imagery maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167140116 This is a technique of visualization or guided imagery that redirects and distracts the patient's focus from painful stimuli. This may include tactile stimuli, listening to music, imagining being on vacation, happy memories, or even focusing on imagining what is physically occurring as the cervix is dilating and labor progresses. This may not completely distract senses of pain, but it helps keep sensory input from reaching the pain center of the cortex.]]> 2022-05-02 17:35:22 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167140116 Breathing Techniques maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167145045 Conscious breathing gives the mother power when engaging in contractions. Effective techniques produce relaxation, pain relief, and redirection of focus onto their breathing. This also promotes adequate oxygenation for not only the mother, but the fetus, considering contractions temporarily halt perfusion and oxygenation to the fetus. Promote slowed breathing, inhaling through the nose, exhaling through pursed-lips, and aiming for 6-9 breaths a minute if able.]]> 2022-05-02 17:38:44 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167145045 Interventions madelinethackeray https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167163650 Morphine:
-Assess level of consciousness, BP, pulse, and respirations 

Fentanyl:
-Monitor respiratory rate and BP frequently
-Caution patient to change positions slowly to minimize orthostatic hypotension

]]> 2022-05-02 17:51:09 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167163650 Coping Strategies https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167163764 Techniques used to manage the pain of labor vary according to geography and culture.]]> 2022-05-02 17:51:14 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167163764 Evaluation maybellemorales https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167165449 Periodically re-assess the effectiveness of pain management strategies, the need to modify pain relief, and be timely with interventions to prevent breakthrough pain. The patient must verbalize the pain is controlled and under their pain tolerance limit on a scale of 0-10, 10 being the worst pain. ]]> 2022-05-02 17:52:22 UTC https://padlet.com/maybellemorales/6ufd2fhtrb99cxsv/wish/2167165449