Managing Discomforts In Labor

1.

Where does physiological pain originate from during labor?
- A.
  
  Visceral pain which comes from the cervix dilating and effacing, uterine distention from T1--> T12, and uterine ischemia
- B.
  
  Somatic pain from stretching of the perineum and pelvic floor and pressure on the bladder and pelvis
- C.
  
  Psychological pain from the distress of child birth.
- D.
  
  Both A and B
Correct Answer
D. Both A and B

Explanation
Physiological pain during labor originates from both visceral and somatic sources. Visceral pain is caused by the cervix dilating and effacing, uterine distention, and uterine ischemia. Somatic pain, on the other hand, arises from the stretching of the perineum and pelvic floor, as well as pressure on the bladder and pelvis. Therefore, the correct answer is "Both A and B" because both of these sources contribute to the pain experienced during labor.

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2.

Expression of pain is NOT
- A.
  
  Emotionally linked
- B.
  
  Related to culture
- C.
  
  Most commonly expressed as increasing anxiety
- D.
  
  The same for all people
Correct Answer
D. The same for all people

Explanation
The expression of pain varies among individuals and is not consistent for everyone. Different people may have different ways of expressing pain, such as crying, screaming, or remaining silent. This can be influenced by various factors like personality, upbringing, and individual pain tolerance. Cultural background and societal norms may also play a role in how pain is expressed, but ultimately, the way pain is expressed differs from person to person, making it not the same for all people.

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3.

Factors influencing pain response do not include:
- A.
  
  Her sexual preference
- B.
  
  Culture and religious beliefs
- C.
  
  Gate-control theory of pain
- D.
  
  Physiologic factors like back pain, gynecological history (like dysmenorrhea)
- E.
  
  Lack of education
Correct Answer
A. Her sexual preference

Explanation
The factors influencing pain response include cultural and religious beliefs, the gate-control theory of pain, physiological factors like back pain and gynecological history, and lack of education. However, a person's sexual preference does not influence their pain response.

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4.

The Gate-Control theory is based on the idea that:
- A.
  
  Pain is related to the amount of people allowed in the delivery room at one time
- B.
  
  Only a limited number of sensations can travel the sensory nerve pathways to the brain at one time
- C.
  
  The size of the cervix and vaginal opening determines the amount of pain the woman will be in
- D.
  
  When in labor, nerve signals to the perineum are cut off completely
Correct Answer
B. Only a limited number of sensations can travel the sensory nerve pathways to the brain at one time

Explanation
The Gate-Control theory proposes that there is a "gate" in the spinal cord that can either allow or block pain signals from reaching the brain. According to this theory, the gate can only handle a limited number of sensory signals at a time, meaning that only a limited number of sensations can travel through the sensory nerve pathways to the brain simultaneously. This suggests that if other non-painful sensations are present, they can potentially "close the gate" and reduce the perception of pain. Therefore, the correct answer is that only a limited number of sensations can travel the sensory nerve pathways to the brain at one time.

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5.

Effleurage is:
- A.
  
  An auditory distraction technique
- B.
  
  Making an incision in the perineum to allow the fetus to pass through the birth canal
- C.
  
  Putting pressure on the lower back to relieve the pain of back labor
- D.
  
  Light, quick stroking of the abdomen, chest, or thighs, usually in rhythm with breathing or contractions
Correct Answer
D. Light, quick stroking of the abdomen, chest, or thighs, usually in rhythm with breathing or contractions

Explanation
Effleurage is a technique used during labor and childbirth where light, quick stroking movements are applied to the abdomen, chest, or thighs. This technique is typically done in rhythm with the woman's breathing or contractions. It is used to provide relaxation and pain relief during labor.

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6.

Water therapy (hydrotherapy) can help labor by:
- A.
  
  Inducing catecholamine production and oxytocin levels, increasing dilation and speeding up labor
- B.
  
  Providing comfortable temperature changes for the mother in localized or general areas
- C.
  
  Increase relaxation and provide distraction from labor pains
- D.
  
  Moisturizing the mother's skin which can get dry from the labor process
- E.
  
  A,B and C
Correct Answer
E. A,B and C

Explanation
Water therapy, also known as hydrotherapy, can be beneficial during labor for several reasons. Firstly, it can induce the production of catecholamines and increase oxytocin levels, which can help to stimulate contractions and speed up the labor process. Additionally, water therapy provides comfortable temperature changes for the mother, either in localized areas or overall, which can help to alleviate discomfort. Moreover, being in water can increase relaxation and provide a distraction from labor pains. Lastly, it can moisturize the mother's skin, which can become dry during labor. Therefore, options A, B, and C are all correct explanations for the benefits of water therapy during labor.

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7.

Transcutaneous electrical nerve stimulation (TENS) is safe to use for pain relief during labor.
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
During TENS, two pairs of electrodes are placed on the thoracic and sacral spine and release low intensity impulses that are turned up in intensity during contractions for approx 1 minute, and cause the release of endorphins.

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8.

Sedatives are used:
- A.
  
  Only before a c-section or an epidural due to the effects on the baby
- B.
  
  Never during the childbirth process
- C.
  
  To relieve anxiety and induce sleep in women who are experiencing a prolonged latent phase of labor
- D.
  
  To stop late decelerations, and given during the transitional phase of the first stage of labor
Correct Answer
C. To relieve anxiety and induce sleep in women who are experiencing a prolonged latent pHase of labor

Explanation
Sedatives are used to relieve anxiety and induce sleep in women who are experiencing a prolonged latent phase of labor. This phase refers to the early stage of labor where contractions are mild and infrequent, and the cervix is not yet fully dilated. During this phase, women may feel anxious or have difficulty sleeping due to the anticipation of labor. Sedatives can help relax the woman, reduce anxiety, and promote restful sleep, which can be beneficial for both the mother and the progress of labor.

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9.

These drugs don't relieve pain, but decrease anxiety, increase sedation, and relieve nausea/vomiting
- A.
  
  Penothiazines (Phenergan, Visatril)
- B.
  
  Benzodiazepines (Valium and Ativan)
- C.
  
  Butorphanol (Stadol)
- D.
  
  Morphine
Correct Answer
A. Penothiazines (pHenergan, Visatril)

Explanation
Benzodiazepines enhance pain relief while phenothiazines decrease anxiety-- both can help with nausea

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10.

Alleviation of sensation of pain or raising the threshold for pain is done by.........

Correct Answer
analgesia
Analgesia

Explanation
Analgesia refers to the alleviation of pain or raising the threshold for pain. It is a medical term used to describe the process of reducing or eliminating the sensation of pain. By using analgesia, healthcare professionals can help patients manage pain and improve their overall comfort. It can be achieved through various methods, such as medication, nerve blocks, or non-pharmacological interventions. Overall, analgesia plays a crucial role in providing relief from pain and improving the quality of life for individuals experiencing discomfort.

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4

Managing Discomforts In Labor

Where does physiological pain originate from during labor?

Expression of pain is NOT

Factors influencing pain response do not include:

The Gate-Control theory is based on the idea that:

Effleurage is:

Water therapy (hydrotherapy) can help labor by:

Transcutaneous electrical nerve stimulation (TENS) is safe to use for pain relief during labor.

Sedatives are used:

These drugs don't relieve pain, but decrease anxiety, increase sedation, and relieve nausea/vomiting

Alleviation of sensation of pain or raising the threshold for pain is done by.........