Common Discomforts of Pregnancy and Comfort Measures Flashcards
What is Nausea and vomiting of pregnancy (NVP)?
NVP is most common in the first trimester, affecting 50% of pregnant individuals; 25% experience nausea only, and 25% are unaffected.
How does NVP differ from hyperemesis gravidarum (HG)?
HG occurs much less frequently, in approximately 0.3%-3% of pregnancies, and is a diagnosis of exclusion when other causes of nausea and vomiting have been explored.
What are nonpharmacologic therapies for NVP?
Nonpharmacologic therapies include prevention, avoiding triggers, small frequent meals, dietary adjustments, and acupressure techniques.
What is a preventive measure for NVP?
Pregnant individuals who take multivitamins at conception are less likely to need treatment for vomiting. It is recommended to take prenatal vitamins 3 months prior to conceiving.
What dietary adjustments can help manage NVP?
Avoid triggers such as odors, eat small frequent meals every 1-2 hours, avoid spicy or fatty foods, and consume high-protein foods.
What should be eaten before getting out of bed to manage NVP?
Bland or dry foods, such as crackers or toast, should be eaten before getting up.
What should be done with prenatal vitamins during NVP?
Discontinue prenatal vitamins with iron until nausea and vomiting have resolved, but continue folic acid.
What alternative therapies are suggested for NVP?
Acupressure, acupuncture, or acustimulation at the P6 (Neiguan) point have conflicting evidence regarding their effectiveness.
What are some common discomforts of pregnancy?
Breast tenderness, backache, fatigue, heartburn, constipation, hemorrhoids, varicosities, leg cramps, presyncopal episodes, headaches.
How can breast tenderness be managed?
Good support brassiere, careful intercourse, reassurance that it will soon pass.
What should be considered for backache during pregnancy?
Differential diagnoses for musculoskeletal strain, sciatica, sacroiliac joint problem, preterm labor, UTI.
What are nonpathologic causes of backache in pregnancy?
Related to normal changes in pregnancy; massage, application of ice or heat, hydrotherapy, pelvic rock, good body mechanics, pillow in lumbar area, pregnancy support harness, good support brassiere, supportive low-heeled shoes.
What are some treatments for sacroiliac joint problems?
Teach appropriate exercises, nonelastic sacroiliac belt, trochanteric belt for joint stability.
What can help manage fatigue during pregnancy?
Reassurance that it is normal, mild exercise, good nutrition, decrease activities, plan rest periods, decrease evening fluid intake.
How can heartburn be alleviated?
Small, frequent meals, decrease fluids with meals, papaya, elevate head of bed, slippery elm bark lozenges, antacids, proton pump inhibitors, H2 blockers.
What are some remedies for constipation during pregnancy?
Increased fluids and fiber, prune juice or warm beverage in the morning, encourage exercise, stool softeners.
How can hemorrhoids be managed?
Avoid constipation, elevate hips, sitz baths, witch hazel or Epsom salt compresses, reinsertion with lubricated finger, Kegel exercises, topical anesthetics.
What are some strategies for managing varicosities?
Support stockings, avoid restrictive clothing, perineal pad, rest periods with legs elevated, avoid crossing legs.
How can leg cramps be addressed?
Decrease phosphate in diet, massage affected leg, flex ankle, keep legs warm, walk, exercise, calcium tablets, magnesium tablets.
What should be done to manage presyncopal episodes?
Change positions slowly, push fluids, regular caloric/glucose intake, avoid lying flat on back, avoid prolonged standing or sitting.
What are some treatments for headaches during pregnancy?
Rule out migraines, head/shoulder/neck massage, acupressure, hot/cold compresses, rest, regular sleep schedule, warm baths, meditation, biofeedback, aromatherapy, eat smaller meals, mild analgesics.
What are the common concerns of pregnancy related to leukorrhea?
- Rule out vaginitis and sexually transmitted infection (STI)
- Good perineal hygiene
- Wear cotton underwear and change as often as necessary
- Unscented panty liners
- Instructions to avoid douching and use of feminine sprays
What are the recommendations for managing urinary frequency during pregnancy?
- Decrease fluids in the evening to avoid nocturia
- Avoid caffeine
- Rule out UTI
What are the suggestions for addressing insomnia in pregnancy?
- Warm bath
- Hot drink - warm milk, chamomile tea
- Quiet, relaxing, minimally stimulating activities
- Avoid daytime napping
What should be considered for round ligament pain during pregnancy?
- Rule out other causes of abdominal pain, such as appendicitis, ovarian cyst, placental separation, inguinal hernia
- Warm compresses, ice compresses
- Hydrotherapy
- Avoid sudden movement or twisting movements
- Flex knees to abdomen, pelvic tilt
- Support uterus with a pillow when lying down
- Pregnancy abdominal support or girdle
What are the treatments for skin rash during pregnancy?
- Ice
- Oatmeal bath
- Diphenhydramine - 25 mg orally every 4 hours as needed for itching
- Dermatology referral, as needed
What are the recommendations for managing carpal tunnel syndrome during pregnancy?
- Good posture
- Lying down
- Rest and elevate affected hands
- Ice, wrist splints
- Mild analgesic - such as acetaminophen 325 mg one to three tabs every 4 hours as needed
