1.3 Flashcards
N/V (1st trimester)
CX:
- Hormonal changes, possibly hCG; may be partly emotional, reflecting pride in, ambivalence, or rejection of pregnant state
Teaching:
- Avoid empty or overloaded stomach; maintain good posture-give stomach ample room; stop smoking; eat dry carbohydrate on awakening; remain in bed until feeling subsides, or alternate dry carbohydrate every other hour with fluids such as hot herbal decaf tea, milk, or clear coffee until feeling subsides; eat 5-6 small meals/day; avoid fried/odorous/spicy/greasy/gas-forming foods
constipation (2nd trimester)
CX:
- GI tract motility slowed because of progesterone, resulting in increased resorption of water and drying of stool; intestines compressed by enlarging uterus; predisposition to constipation because of oral iron supplementation
teaching:
- Drink 2L (8-10 glasses) of water/day; include roughage in diet; engage in moderate exercise; maintain regular schedule for BMs; use relaxation techniques and deep breathing; do not take stool softener, laxatives, mineral oil, other drugs, or enemas without first consulting primary HCP
indigestion (2nd trimester)
CX:
- Heartburn; progesterone slows GI tract motility and digestion, reverses peristalsis, relaxes cardiac sphincter, and delays emptying time of stomach; stomach displaces upward and compressed by enlarged uterus
teaching:
- Limit or avoid gas-producing or fatty foods and large meals; maintain good posture; sip milk for temporary relief; drink hot herbal tea; primary HCP may prescribe antacid between meals; contact primary health care provider for persistent symptoms
urinary frequency (1st trimester
CX:
- Vascular engorgement and altered bladder function cx by hormones; bladder capacity reduced by enlarging uterus and fetal presenting part
teaching:
- Empty bladder regularly; perform Kegel exercises; limit fluid intake before bedtime; wear perineal pad; report pain or burning sensation to primary health care provider
fatigue (1st trimester)
CX:
- Increased levels of estrogen, progesterone, hCG or by elevated basal body temperature; physiological response to pregnancy and its required physical and psychological adaptations
teaching:
- Rest as needed; eat well-balanced diet to prevent anemia
ptyalism (1st trimester)
(excessive salivation)
CX:
- Possibly cx by elevated estrogen levels; may be r/t reluctant to swallow because of nausea
teaching:
- Use astringent mouthwash, chew gum, eat hard candy as comfort measures
round ligament pain (2nd trimester)
CX:
- stretching of uterus caused by enlarged uterus; tenderness
teaching:
- Not preventable; rest, maintain good body mechanics to avoid overstretching ligament; relieve cramping by squatting or bringing knees to chest; sometimes heat helps
mood swings (1st trimester)
CX:
- hormonal and metabolic adaptations; feelings about female role, sexuality, timing of pregnancy, and resultant changes in life & lifestyle
teaching:
- Participate in pregnancy support group; comm. Concerns to partner, family, and HCP; request referral for supportive services if needed (financial assistance)
increased vaginal discharge (d/c) 1st trimester
CX:
- hormonally stimulated cervix becomes hypertrophic and hyperactive, producing abundant counts of mucus
teaching:
- Not preventable; do not douche; wear perineal pads; perform hygienic practices such as wiping front to back; report to primary health care provider if accompanied by pruritus, foul odor, or change in character or color
headaches (thru week 26)
CX:
- Emotional tension (more common than vascular migraine headache); eye strain (refractory errors); vascular engorgement and congestion of sinuses resulting from hormone stimulation
teaching:
- Conscious relaxation; contact primary HCP for constant “splitting” headache to assess for preeclampsia; OTC analgesics may be used if recommended by health care provider
ankle edema (3rd trimester)
CX:
- edema aggravated by prolonged standing, sitting, poor posture, lack of exercise, constrictive clothing or hot weather
teaching:
- Ample fluid intake for natural diuretic effect; put on support stockings before arising; rest periodically with legs and hips elevated; exercise moderately; contact HCP if generalized edema develops; diuretics are contraindicated
presumptive s/s
those changes felt by the woman (amenorrhea, fatigue, breast tenderness, n/v, urinary frequency, quickening vs. gas)
probable s/s
those changes observed by an examiner (Hegar sign, ballottement, pregnancy tests, pelvic vascular congestion [Chadwick’s sign], enlarged abdomen, skin changes)
positive
those signs attributed only to the presence of the fetus (fetal heart tones, visualizing the feta on US, palpating fetal movements, delivery)
