Editing Maternal and Newborn Nursing (section)

=== Comfort and anesthesia ===

Nonpharmacologic measures include position changes and ambulation, hydrotherapy, counterpressure to the sacrum for back labor, breathing techniques, effleurage, heat and cold, and continuous labor support.

'''Epidural analgesia''': the most common serious immediate complication is '''maternal hypotension''' with resulting decreased uteroplacental perfusion and fetal heart rate change. Nursing care: IV access with a fluid bolus per protocol before placement, position the patient sitting or side-lying with the back curved, monitor blood pressure frequently (a common pattern is every 2 to 5 minutes for the first 15 to 20 minutes), have the patient void or place a catheter because bladder sensation is lost, keep the patient off her back, and implement fall precautions. Treat hypotension with lateral positioning, a fluid bolus, oxygen, and a vasopressor such as ephedrine or phenylephrine per order. Other risks are pruritus, fever, urinary retention, and postdural puncture headache.

'''Opioids''' given close to birth can cause neonatal respiratory depression; naloxone should be available, and it is not given to a newborn of an opioid-dependent mother because it can precipitate withdrawal and seizures.