Pain Management for the Obstetric Patient
USING APA FORMAT, WRITE( 7) PAGES PAPER EXCLUDES COVER AND REFERENCES PAGE THAT ADDRESSES THE COMFORT AND PAIN RELIEF NEEDS OF THE ANTEPARTUM, INTRAPARTUM AND POSTPARTUM PATIENT.
A MINIMUM OF( 3 ) CURRENT PROFESSIONAL REFERENCES MUST BE PROVIDED.
CURRENT REFERENCES INCLUDE PROFESSIONAL PUBLICATIONS OR VALID AND CURRENT WEBSITES DATED WITHIN (5) YEARS.
ADDITIONALLY, A TEXTBOOK THAT IS NO MORE THAN 1 EDITION OLD MAY BE USED.
THE PAPER CONSIST OF 2 PARTS
PART 1 LOOKS AT THE CAUSES AND MANAGEMENT INTERVENTIONS OF DISCOMFORT AND PAIN DURING PREGNANCY, LABOR, BIRTH AND RECOVERY FROM BIRTH. PART 2 IS A COMPONENT OF A TEACHING PLAN THE REGISRERED NURSE WOULD USE TO ASSIST AN ANTENATAL PATIENT MAKE AN INFORMED DECISION REGARDING PAIN RELIEF MEASURES TO BE USED DURING LABOR AND BIRTH.
PART 1- IDENTIFY AND EXPLAIN (2) SOURCES OF PAIN FOR THE ANTEPARTUM PATIENT, INTRAPARTUM PATIENT, AND POSTPARTUM PATIENT DURING AN UNCOMPLICATED PREGNANCY, LABOR, AND RECOVERY FROM THE BIRTHING PROCESS
2- IDENTIFY (1) PHARMACOLOGIC AND (2) NON PHARMACOLOGIC PAIN MANAGEMENT MEASURES FOR THE INTRAPARTUM PATIENT. EXPLAIN THE BENEFITS AND RISKS OF EACH OF THESE PAIN MANAGEMENT MEASURES.
PART 2- IN ORDER FOR A WOMAN TO MAKE AN INFORMED DECISION REGARDING PAIN RELIEF MEASURES TO BE USED IN THE INTRAPARTUM PERIOD, THE INFORMATION NEEDS TO BE PROVIDED IN THE ANTEPARTUM PERIOD.
BEFORE FINILIZING A TEACHING PLAN FOR THE PREGNANT WOMAN, HER HISTORY NEEDS TO BE ASSESSED TO DETERMINE ANY VARIABLES THAT MAY AFFECT THE CONTENT OF THE TEACHING PLAN. FOR EXAMPLE, ARE THERE ANY LANGUAGE VARIABLES/BARRIERS THAT WILL AFFECT CARE PROVIDED DURING LABOR AND BIRTH?
A- IDENTIFY(3 )VARIABLES UNIQUE TO THE PREGNANT PATIENT THAT NEED TO BE CONSIDERED WHEN DEVELOPING A PATIENT SPECIFIC PAIN MANAGEMENT TEACHING PLAN FOR THE ANTEPARTAL PATIENT PREPARING FOR LABOR AND BIRTH. PROVIDE AN EXPLANATION WHY EACH OF THESE( 3 )VARIABLES NEEDS TO BE CONSIDERED WHEN DEVELOPING A TEACHING PLAN FOR AN OBSTETRIC PATIENT
B- SELECT (2) NON PHARMACOLOGIC PAIN RELIEF OPTIONS USED IN THE INTRAPARTUM PERIOD. FOR EACH OPTION, EXPLAIN (3) SPECIFIC POINTS OF INFORMATION RELATED TO THIS PAIN RELIEF OPTION THAT NEEDS TO BE TAUGHT TO THE PATIENT. INCLUDE RATIONALES FOR EACH PIECE OF CONTENT REGARDING WHY YOU WOULD NEED TO INCORPORATE THIS INFORMATION.
Pain Management for the Obstetric Patient
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Pain Management for the Obstetric Patient
PART 1
Introduction
Pain is subjective and people have different experiences as far as pain is concerned. When an individual feels pain, there is the tendency to respond with certain expressions and other coping behaviors (Carr, Christensen, & Layzell, 2010). However, individuals respond to pain uniquely and this depends on different factors such as the level of fear, cultural background, fatigue, previous experiences with pain and individual tolerance to pain among others. For women in labor, pain is a common thing. Different stages of labor experience different forms and levels of pain. Various ways or measures exist through which a woman in labor can use to manage pain. These include both pharmacologic and nonpharmacologic methods of pain management (Vadivelu, Urman, & Hines, 2011). During labor, one can employ the use of a single method of managing pain, or a number of different methods can be used depending on the level of pain being experienced by the patient. In understanding the subject topic, it is important to understand the sources of pain during pregnancy and labor period. This paper would further identify different pain management measures for the intrapartum patient, pinpointing some of the benefits and risks associated with each. In addition, the paper will discuss the various factors to be considered when developing a teaching plan for expectant women of various special needs.
Sources of Pain for the Antepartum Patient
The anterartum is the period before birth. During this time, women with uncomplicated pregnancies may experience some pain, which do not have to be a source of worry. Some of the common sources of pain in this stage may be related or unrelated to the pregnancy. During the development of pregnancy, the ligaments attached to the uterus stretches causing some discomfort or pain in the lower abdomen region. Backache is another common pain during anterartum. This problem is caused by the expansion of the pelvis as it becomes lax when the pregnant women approached the labour period. Sometimes, the backache is heightened by wrong postures. For instance, as the abdomen enlarges, the woman may have the tendency to push the tummy outwards, which may worsen the pain.
Sources of Pain for the Intrapartum Patient
During the labor period, pregnant women are susceptible to various pains. The levels of such pains depend on individuals and are influenced by different factors such as fear, anxiety, and age among others (Lesch, 2014). One of the most common causes of labor pains is the contraction of uterine walls. During labor, the cervix and the lower uterine segment dilate to allow the movement of the fetus towards pelvic. The second source of pain occurs during pushing. As the fetus approaches, the pelvic, greater pressure occurs at the presenting part of the pelvic structures and other surrounding structures. Usually, these structures are pain sensitive and hence the process causes severe pain to the delivering mother. The vagina also experiences unbearable pain as it stretches to allow the passage of the baby.
Sources of Pain for the Postpartum Patient
After the birth of a child, mothers usually experience changes in their bodies that may cause some discomfort or pain. For instance, during some few days after childbirth, after-pains occur because of cramping or the contractions of the uterus (Lesch, 2014). Such pains may last for up to ten days, but the intensity of the pain reduces gradually from the third day after delivery. Another source of pain after child delivery comes from constipation. Normally, the movement of the first postpartum bowel is experienced a few days after delivery. During this time, one has sensitive hemorrhoids and sore muscles, which make it painful. In other cases, the mothers with healing episiotomies experiences severe pain as the bowel movement causes some stretching of the healing part. This causes unbearable pains that sometimes prevent the person from sitting down.
Pain Management Measures for the Intrapartum Patient
Labor pains may have adverse psychological and physiological consequences to the patient. Some of the common effects of pain to an intrapartum patient include respiratory disorders such as hyperventilation and respiratory acidosis. Pain also results in increased cardiac output causing blood pressure. This could be dangerous to patients previously suffering from blood pressure. The release of neuroendocrine owing to severe pain may increase the secretion of maternal catecholamine, which may have the risk of causing uteroplacental constriction (Carr, Christensen, & Layzell, 2010). Labor pains are also known to have psychological effects to women in intrapartum patients. It is believed that severe pains during labor contribute to long-term emotional stress, which may have adverse consequences on the patient mental health and even on family relationships. Owing to these negative consequences of labor pain, it is important that the patient seek appropriate pain management measures to help in resolving the issue. When planning for a particular pain management measure, the safety of the fetus and that of the mother must be the first consideration a nurse or practitioner should have in mind.
There are two types of measures used in resolving labor pains. These include pharmacologic and non-pharmacologic pain management measures. Each of the measures has some benefits associated with them, but again they have certain risks that may pose some dangers to the intrapartum patient.
Pharmacologic Pain Management Measure
Pharmacologic pain management entails the use medicine to relieve or eliminate pain during labor. There are two common approaches of pharmacologic pain management, which include the use of analgesia and anesthesia. Most of women in labor are familiar with the use of anesthesia as this is commonly used during labor to eliminate pain perceptions. This happens because anesthesia interrupts the nerve impulses to the brain inhibiting the feeling of pain. Anesthesia is of two types, which are the general anesthesia and regional blocks. General anesthesia is uncommon as it is used only during emergency situations. Regional blocks are the most commonly used anesthesia. This type of anesthesia consists of epidural block, paracervical nerve block, pudendal block, and spinal block (Carr, Christensen, & Layzell, 2010). Pudendal block is used provide local anesthesia to vulva, rectal areas and the perineum during the delivery processes. Epidural block is administered at the epidural space to eliminate all sensation from the umbilicus level to the thighs. This relives of all pain and discomfort caused by uterine contractions, fetus movements, pressure, and pain from the stretching perineum. Spinal block is administered in the spinal fluid and this helps in eliminating all sensation from the feet up to the level of the nipples.
The major benefits associated with all approaches of anesthesia is that the process is easy to perform to patients and they help eliminate all the pains and discomfort completely, making delivery process easy and pa...