Exam 3 - Common Discomforts of Pregnancy Flashcards
When is morning sickness most common during pregnancy?
First trimester
- Peaks at 11 weeks and lasts 5-6 weeks
- Can go into second trimester
- Can progress past 20 weeks if multiple gestations
- Resolves around 14-16 weeks
What is thought to be the cause of morning sickness?
Rising hCG levels in early pregnancy, usually subsides after first trimester when hCG levels drop
Non pharmacological interventions for morning sickness
- Small frequent meals
- Eat crackers, toast, Cheerios before getting out of bed
- Carbonated drinks (e.g. ginger ale)
- Acupuncture, ginger
- Skip prenatal vitamins and just take folic acid
Medications used to treat morning sickness
- Vitamin B6 (pyridoxine) supplement
- Doxylamine (Unisom) - antihistamine
- Used during first trimester
- Has been reformulated to Diclegis - only FDA approved med for N/V
- Requires prescription - expensive
Can zofran be used to treat morning sickness?
“Off label” use
- Recent evidence found use in first trimester showed increase risk of heart defects and orofacial malformations
- Remains category B
What causes pregnant women to be constipated?
- Decreased peristalsis
- Decreased physical activity
- Iron supplements
How to prevent constipation during pregnancy?
- Take bulk forming laxatives and stool softeners (e.g. colace, milk of magnesia, metamucil)
- Increase fluid intake
- High fiber diet
What should constipated pregnant women NOT take for treatment?
Avoid stimulant laxatives
What is leukorrhea?
Profuse, thin (or thick), clear to milky white, no odor vaginal discharge produced by epithelial cells in vagina and cervix
What causes leukorrhea during pregnancy?
Due to hormone levels
When do patients first notice leukorrhea during pregnancy?
Begins during second trimester
What can leukorrhea form during pregnancy?
Forms mucus plug to protect bacteria from entering cervix
- Mucus plug lost when cervix begins to soften and prepares for labor
Relief methods for leukorrhea
- Avoid douching or using feminine hygiene products to clean perineum or vagina
- Unscented cotten panty liners
- Wear cotton underwear
What causes round ligament pain?
Ligaments pan through inguinal canal –> during pregnancy, ligaments hypertrophy as the uterus grows –> pain because ligament is lengthening and pressure from enlarging uterus
How can you relieve round ligament pain?
Stretching
What can round ligament pain also be confused for?
Preterm labor, appendicitis, inguinal hernia, muscle strain, GI pain (e.g. constipation, gas)
When is lower back pain most prevalent for pregnant women?
Last half of pregnancy
- Intensifies with progression of pregnancy d/t increasing weight of uterus and relaxation of sacroiliac ligaments
When is upper back pain most prevalent in pregnant women?
Early in pregnancy d/t increased size and heaviness of breasts –> muscle strain if breasts are not adequately supported
Relief measure for back pain
- Education about proper body mechanics
- Stoop rather than bend, lift legs and not back, spread feet apart and place one foot slightly in front of other when stooping
- Wear supportive low heeled shoes
- Apply local heat, massage therapy, ice
- Supportive mattress and bra
- Acetaminophen (avoid NSAIDs)
- Stretching, exercise, yoga, swimming
What is supine hypotensive syndrome?
Lightheadedness and dizziness that occurs when lying in supine position d/t weight of uterus resting on IVC
- Venous blood return inhibited
- Reduced blood filling of heart
- Lowers CO
Also compresses aorta –> decreases arterial pressure
Supine hypotension syndrome relief measures
Have patient turn on left side or sit up
What causes pregnant women to have numb and/or tingling fingers?
Due to change in center of gravity, pulling shoulders, neck, head out of normal alignment
- Places pressure/traction on nerve and arm –> paresthesia of fingers
- Physiologic edema can also exert pressure on nerve supplying hands and cause carpal tunnel syndrome
Are symptoms of numbness and tingling bilateral or unilateral?
Bilateral
When do symptoms of numbness and tingling normally occur during pregnancy?
Begins in second or third trimester of pregnancy
- Usually resolves spontaneously during postpartum period
Treatment for numbness and tingling in fingers during pregnancy
- Wrist splints
- Keep wrist in neutral position
- Wear splint while sleeping or during waking hours
