Pregnancy Flashcards
What should be avoided in pregnancy?
- Smoking
- Alcohol
- Vitamin A
- Mould ripened cheeses, raw egg
- No more than 2 cup coffee a day/4 cup tea
- Avoid raw meats
What should be taken in pregnancy?
- 10mcg vit D daily
- 400mcg folic acid
- 5mg folic acid if certain medicines
What can be suggested for morning sickness?
When would you refer?
- Ginger biscuit
- Food before rising e.g toast
- Small amounts of water regularly
- Small carb rich snacks throughout day
- Avoid triggers e.g foods, smells
REFER:
- Dark urination (dehydration)
- Abdo pain
- Fever
- Weakness/faint
- Blood in vomit
- Uncontrollable vomiting
- Cant keep fluids or foods down for 24hr period (dehydration)
What type of pain may pregnant women experience?
When would you refer?
- Headaches
- Backpain (strain on muscles)
- Leg/foot ache
- Unbearable pain
- If headache could be preeclampsia (check had BP and urine tests at antinatal clinic)
What would you suggest for pain management in pregnancy?
LIFESTYLE
- Paracetamol
- AVOID NSAIDS AND ASPIRIN
- Do not sit or stand for too long
- Rest when painful and put feet up
- Wear flat shoes
- Stretch tight muscles
- Have warm baths
- Massage
Why might heartburn occur in pregnancy?
How can it be treated?
AVOID?
- Inc in pressure on stomach
- Posture
- Food content
- LIFESTYLE:
- Small freq meals, avoid trigger foods (spicy, fatty)
- Do not eat immediately before bed
- Stop smoking if applicable
- SIMPLE ANTACIDS/ALGINATES
- Rennies
- Gaviscon
AVOID PPI OR H2 ANTAG
When might you refer heartburn in pregnancy?
- Unresponsive to treatment
- Unable to eat due to symptoms
- Alarm symtoms
- Blood in stools, excessive vomiting
- Has IBS, history of peptic ulcers etc…
Why might constipation occur in pregnancy?
- Reduced activity
- Reduced GI motility
- Taking supplements? IRON OR AL
What can be suggested for constipation in pregnancy?
- Lifestyle:
- Increase water consumption
- Fibre in diet
- Light exercise
- Do not resist urge to pass stool
-Laxatives:
- Bulk forming
- Osmotic
(safe as not absorbed)
When should you refer constipation in pregnancy?
- If lifestyle and laxatives suggested fail to work
- Blood in stools
Why are haemorrhoids common in preg?
- How do you treat them
- Lifestyle?
- Inc pressure on stomach
- ENSURE PREVIOUS DIAGNOSIS
- Anusol cream
- AVOID HYDROCORTISONE PREPS
- Do not resist urge to pass stool
- Ensure adequate fluid intake
- Ensure fibre in diet
What happens if a lady presents with curd like discharge and vaginal itching?
The discharge doesn’t smell and is white rather than green/yellow
She is pregnant.
Lifestyle advice in the meantime may include?
- Inform that she may be experiencing thrush
- It is common in pregnancy due to increased oestrogen and sugar levels
- Due to the fact that she is pregnant, no OTC preparations can be recommended
- CLOTRIMAZOLE OTC CREAMS NOT LICENSED IN PREG
- Referral to GP is required to confirm diagnosis and to prescribe treatment
- Advise to avoid tight fitting clothing
- Cotton underwear to allow to breathe
- Avoid perfumed products
- INSERT PESSARIES SUGGESTED BY GP USING FINGER RATHER THAN APP
What should be suggested for a pregnant lady with leg cramps?
- They are common due to hormone and weight changes
- Lifestyle advice:
- Rest legs and put feet up
- Stretching exercises
- Massaging of muscle
DO NOT USE QUININE
A pregnant lady asks for advice on cough and cold treatments.
What should you suggest?
- AVOID decongestants and take care with combination preps
- AVOID opioid cough suppressants
- Suggest paracetamol for pain relief
- Menthol inhalers for congestion e.g vicks
- Demulcants e.g glycerol cough syrups to sooth
LIFESTYLE:
- Steam inhalations to decongest
- Warm foods/liquids e.g soup, honey and lemon drink
- Sweets to suck on to soothe throat
What should happen if a pregnant women comes into the pharmacy asking for threadworm treatment?
- Ask who the product is for
- If she says for the family then counsel
- Over 2 months can be treated CANT be used in pregnancy
- If asymptomatic, treat family and try to break cycle through hygiene measures
- If symptomatic then see GP for advice
Why is breastfeeding recommended?
- How long for
- Exclusive breastfeeding for first 6 months of life
- Bonding with baby
- Nutritionally complete
- Provides antibodies in colostrum (IgA)
- Prevents diarrhoea,
- Lower levels of sudden infant death syndrome
- Cost effective
- Burns calories for mother
- Less likely for mother to develop certain cancers, oesteoporosis
- Less likely for baby to develop diabetes, high blood pressure, obesity
Why might a women decide to bottle feed?
- Other people can feed baby
- Issues with breastfeeding (lack of milk production, baby not taking)
- Embarrassed
- Medical condition e.g HIV
What two types of infant milks are there?
- Whey based - birth to 12 months
- Similar to breast milk
- 60% whey 40% casein protein
- Casein based - birth to 12 months
- Hungrier babies, similar to cows milk
- 20% whey 80% casein protein
What happens when a child is starting to be weaned and was drinking Casein or Whey based infant milks?
- Follow on milk
- from 6-12months
- Weaning diet
- Nutritionally superior to cows milk
- Contains more iron than cows milk
What can a child drink after follow on milk from 1 year?
- Toddler milk
- Similar to cows milk in protein composition but fortified with minerals and vitamins
What should be done when making up infant formula?
- Sterilise bottles and teats
- Clean surfaces
- Follow instructions - boil and cool water
- Don’t reheat feeds
- Don’t leave feeding baby unattended
