a nurse is planning care for a client who is in labor and is requesting epidural anesthesia This is a topic that many people are looking for. bluevelvetrestaurant.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, bluevelvetrestaurant.com would like to introduce to you Care of a Woman with an Epidural – 5 Rules for Good Support. Following along are instructions in the video below:
Im penny simkin and i want to talk with you about the care of of a woman with an epidural and this is a bit of a bone. I to pick with usual management. Many women with an epidural are left to lie in bed.
In one position for hours on end and when that happens the baby kind of gets stuck in one position. The babies are use of having their mothers move around in labor and if the mother stuck in a position. So is the baby likely to be and we do have a problem with epidurals of having a higher rate of forceps deliveries vacuum deliveries because babies are mal positioned so i have some kind of guidelines that id like to offer you to keep birth as normal as possible even when a woman does have an epidural and cant feel what is going on with her contractions.
So im speaking to your partner. As much as to you im speaking to doulas everywhere. Im speaking to care providers nurses midwives physicians and my my whole shtick is treat a woman with an epidural as much as possible like a woman who does not have one women who dont have an epidural move around a lot for example they want to seek comfort and so were going to talk about five rules.
Here and they all start with the word keep the first one is keep her moving so even though. Shes not able to walk or or it possibly cant move around in bed. Very much she can be helped to roll from one side to the other she can be helped to come up to a sitting position and down.
She might if she has a nice light block be able to kneel over a birth ball up on the upon the bed all those positions changed the effects of gravity. But also helped to change the shape of the pelvis so she may be able to do many of the things that a woman without an epidural could do and do her baby. A favor by helping the baby come down through so keep her moving now the other thing next one keep her cool.
Ive mentioned before that fever is a not uncommon side effect of the epidural. The the epidural blocks our sensory nervous system our ability to feel. But it also blocks the temperature.
Regulating system so heat tends to accumulate and when that happens. The woman can develop a fever. So how can we help to prevent that well my advice is if we see any trend in an increasing temperature maybe its at 98 degrees.
And then half an hour later its about 98 4. And then its the next time. Its 99.
We see the temperature going up instead of just waiting and hoping it doesnt go up too high lets start cooling her down. So keep her cool and that would mean turn on a fan mop her brow with a cool cool cloth. If she has lots of blankets on her get those off and and sometimes we use ice packs over her chest.
So her bad upper back the parts of her body that are not numb. We cooled. The parts of her body that are not numb.
So that can help to prevent her developing a fever and help prevent the baby from getting overheated in utero. Now. The third one is many women who have an epidural often feel neglected emotionally.
Oh. Shes comfortable now i can go get us something to eat or i can turn on the game. And shes feeling like no one is really caring for her the myth that the nurse is is often there.
But shes in and out. And shes really focusing on keeping everything keeping all the technology going. Shes checking the monitor.
Shes checking your iv. Shes checking the density of the epidural. So she isnt spending a lot of time and emotional support many women will say gosh as soon as i got the epidural.
I felt like everybody event abandoned me. And psychologically that can be very stressful and and also sometimes women want to ask questions want some help getting something to drink or moving or something. And they dont have the person to ask so keep her company do not leave the woman with an epidural even if shes asleep because she sleeps lightly shell wake up and shell think where is everybody and i learned as a doula.
I learned this the hard way because i did leave women when they were asleep and then i find that my gosh the babys heart rate dropped and her blood pressure dropped and i wasnt there to help her at that time so dont leave her. I always have partner doula. Someone whos there as part of her team by her side.
So thats the third one and then we want to help her keep from pushing too early. Sometimes when the woman is fully dilated cervix is fully dilated. Shell be told okay you can start pushing now.
And she pushes and pushes and pushes and gets nowhere and then theres a cesarean in the second stage of labor. We dont want that so our idea would be wait until she feels something as the baby moves down. Many women with an epidural will start to feel the baby in the birth canal and theyll start to feel like pushing or theyll know theyre having a contraction thats when they should begin pushing not when someone finds out that her cervix is dilated.
All the way to 10 centimeters. So she may we call this laboring down. And thats waiting until the the head is visible right at her vaginal outlet or shes having a strong urge to push then shell push with that urge and shell push for a shorter time.
But our outcomes are better than having her pushing from the moment. Shes fully dilated and our last rule is keep her skin to skin with her baby. After the birth.
The baby should not be taken away unless. Theres some real medical reason. But most in most hospitals routine care says take the baby away check all the vital signs.
Maybe give a quick bath. Then bring the baby back to the mother that it will delay the onset of breastfeeding. But it also helps to postpone that bonding that happens between mother and child when a baby is skin to skin with the mother baby can smell her the baby can lick the baby can seek the breast and if if the baby is given its own time to find its way to the breast of breast feeding is going to get off to a much better start so those are five rules.
Ill see if i can remember them keep her moving keep her cool keep her company keep her from pushing too early and keep her skin to skin with her baby. Thank you very much you nullius in verba on the word of no one the motto of the royal society of london founded in 1660. Al r z.
Advocated this approach to medicine circa the year 900 over seven hundred years earlier but if you were really a medieval italian medical student. The book youd read probably wouldnt be by hippocrates galen or. Al r z .
Instead. Youd read a translated encyclopedia featuring all of them. In doing so.
Youd participate in the scientific wonder called scholasticism or learning through close readings of approved texts that recorded the observations and theories of earlier thinkers. Take it away thought bubble. One of the all time greatest hits of medical education was al q n n f.
Al ibb or the canon of medicine. The canon was written by another persian polymath ibn sina born in 980 ibn sina was widely seen as the best writer to summarize and comment on the greco roman. Doctors his canon became one of the most important medical textbooks and introductions to aristotles physics for six hundred years.
Your textbook is really a mashup of several different books. Each page is like an onion at its heart. One punctum or big idea by aristotle or hippocrates or galen.
These are surrounded by layer upon layer of annotatio or notes by famous physicians from distant cities such as baghdad your main throughline are the summaries by ibn sina whose. Name has been latinized as avicenna . But there are notes by latin translators such as gerard de cremona or constantinus africanus.
Plus outer layers of notes by other medical students maybe you even jot down your own thus way before webmd youre in conversation with doctors from all across space and time in universities. Such as bologna or salerno. You might also have access to another textbook.
This one by wait for it a lady trota of salerno wrote practical medicine. According to trota and treatments of women. One of books of the the trotula ensemble.
This group of three texts from around 1200 traveled widely throughout medieval europe. The trotula became foundational to gynecology and all other topics related to womens health. But you might not know that this foundational text on womens health was written by a woman because her identity was systematically written out of history until the late twentieth century because of course.
It was thanks thought bubble so what was life for many educated people in asia and north africa between roughly 400 bce to ce 1300 life was a universal property of which humans were just interesting examples life was linked to the movements of special fluids. Which were the objects of medical treatments life was ultimately built out of a smaller number of elements and good health meant balancing fluids and elements in the right way how did we know what life is for some physicians in classical greece or imperial rome. Careful observation and comparison to animals were crucial methods persian doctors influenced by both greek and indian ideas synthesized earlier ideas expanded evidence for them and challenged and reworked them why did you medieval citizen trust this information because books told you to and with that dear student.
We leave you to deal with the black plague of 1347 bummer next time well deep dive into the eternal question of what is stuff with a group of thinkers who tried to science lead into gold. The alchemists crash course history of science is filmed in the dr. Cheryl c.
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