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NURS 681A Antenatal and Gynecology for the Midwife > Varneys Ch 23 Discomforts of PREG > Flashcards

Varneys Ch 23 Discomforts of PREG Flashcards

1
Q

What is the presumed cause of dyspnea in pregnancy?

A

diaphragm displacement

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2
Q

What are some differential diagnoses of dyspnea in pregnancy?

A
  1. w/ tachycardia=anxiety/panic
  2. respiratory infection
  3. cardiac d/o
  4. pulmonary embolism
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3
Q

What is the cause of dependent edema in pregnancy?

A

Impaired venous circulation, increased venous pressure in lower extremities from enlarged uterus.

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4
Q

What are some differential diagnoses of dependent edema in pregnancy?

A
  1. DVT
  2. Preeclampsia
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5
Q

What are strategies to decrease dependent edema in pregnancy?

A
  1. exercise
  2. avoid prolonged sitting or standing
  3. Elevate legs periodically
  4. compression socks
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6
Q

What is the cause of syncope or dizziness in pregnancy?

A

enlarged uterus impairs venous return causing hypotension.

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7
Q

What are some differential diagnoses of syncope or dizziness in pregnancy?

A
  1. hypoglycemia
  2. seizure d/o
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8
Q

What is the cause of varicosities in pregnancy?

A

venous distention from increased venous pressure and vasodilation. most common in legs or vulva.

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9
Q

What are strategies to decrease varicosities in pregnancy?

A
  1. rest the effected extremity.
  2. wear compression socks
  3. wear pregnancy support belt or vulvar varicosity garment.
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10
Q

What is the cause of constipation in pregnancy?

A

progesterone slows motility of GI tract, pressure on GI tract from uterus, and sometimes iron supplements.

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11
Q

What are strategies to decrease constipation in pregnancy?

A
  1. increase fluids
  2. warm liquids to stimulate peristalsis
  3. increase fiber
  4. bulk-forming laxatives, stool softeners, glycerin suppositories
  5. Avoid stimulant laxatives and castor oil
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12
Q

What are strategies to decrease gas pain in pregnancy?

A
  1. exercise
  2. caffeine - stimulates motility
  3. knee-chest position
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13
Q

What is the cause of heartburn in pregnancy?

A

progesterone induced relaxation of the LES, slower emptying of gastric contents, and reduced stomach capacity

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14
Q

What are strategies to decrease heartburn in pregnancy?

A
  1. small, frequent meals
  2. avoid aggravating foods
  3. Elevate HOB, avoid lying down after eating
  4. antacids, H2 receptor antagonists, PPIs
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15
Q

What are strategies to decrease ptyalism (excessive saliva production) in pregnancy?

A

chew gum or suck on hard candy

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16
Q

What are strategies to decrease low back pain in pregnancy?

A
  1. proper body mechanics
  2. exercises-pelvic rock, maternity belt
  3. heat or ice packs
  4. chiropractic, acupuncture, massage, yoga
  5. Acetaminophen, muscle relaxant for sprain/strain, tricyclic antidepressant for chronic low back pain.
17
Q

What are strategies to decrease leg cramps in pregnancy?

A
  1. straighten effected leg and dorsiflex the ankle
  2. magnesium at bedtime to bowel tolerance
18
Q

What is the cause of sciatica in pregnancy?

A

pressure on the sciatic nerve from joint laxity, elicited from twisting, lifting or moving leg.

19
Q

What are strategies to decrease sciatica in pregnancy?

A
  1. heat, ice, abdominal support
  2. avoid twisting, good body mechanics
  3. acetaminophen - max 400 mg/day
  4. chiropractic or PT
20
Q

What is the cause of dyspareunia (pain with sex) in pregnancy?

A

progesterone-induced relaxation of veins in pelvis and enlarged uterus causing pelvic venous congestion

21
Q

What are strategies to decrease dyspareunia (pain with sex) in pregnancy?

A
  1. position changes
  2. water-based lubricant
  3. treat vaginitis if indicated
  4. screen for sexual abuse
22
Q

What is the cause of leukorrhea (vaginal discharge) in pregnancy?

A
  1. high estrogen levels causing profuse white or clear discharge.
  2. r/o STI, BV, Candida, PROM.
23
Q

What are strategies to decrease dyspareunia (pain with sex) in pregnancy?

A
  1. avoid douching, feminine sprays
  2. education that it is a normal sx
24
Q

What is the cause of round ligament pain in pregnancy?

A

increase in length of round ligaments as uterus rises and sudden stretching.

25
Q

What are strategies to decrease round ligament pain in pregnancy?

A
  1. wear maternity belt
  2. proper body mechanics
26
Q

What is the cause of urinary frequency and nocturia (nighttime urination) in pregnancy?

A

decreased bladder capacity from increased pressure of uterus, increased blood volume and GFR=increase urine production

27
Q

What is the cause of fatigue in pregnancy?

A
  1. progesterone, increased energy requirements of pregnancy, and disrupted sleep
  2. r/o anemia, depression, cardiac d/o, thyroid d/o, infection
28
Q

What is the cause of gingivitis in pregnancy?

A

pregnancy changes in oral mucosa increase likelihood of gingivitis.

29
Q

What are strategies to decrease insomnia in pregnancy?

A
  1. warm baths
  2. avoid caffeine
  3. regular exercise
  4. diphenhydramine (Benadryl) 50-100 mg, doxylamine succinate (Unisom) 25 mg
30
Q

What is the cause of nasal congestion and epistaxis (nosebleed) in pregnancy?

A

estrogen effect that causes hyperemia (increased blood flow) in nasal passages

31
Q

What is the cause of numbness/tingling in fingers in pregnancy?

A
  1. kyphosis (rounding of upper back) places pressure on nerves in the arm causing tingling and numbness of the fingers.
  2. edema in wrist/hands causes temporary carpal tunnel syndrome sx
  3. often occurs at night and exacerbated by edema in arms and hands
32
Q

What are strategies to decrease numbness/tingling fingers in pregnancy?

A
  1. move arms at level of shoulder to decrease pressure on nerves when tingling starts
  2. wrist splints to keep wrist in neutral position, wear while sleeping, work, activities
33
Q

When is the usual presentation of N/V in pregnancy?

A

begins week 5-6, peak at 9 weeks, subsides by 16-20 weeks. Incidence is 88%=some N/V and 6.4%=severe N/V

34
Q

What screening can be used to evaluate N/V?

A

PUQUE score, weight, BP, CMP, UA

35
Q

What are non-pharmacological ways to reduce N/V in pregnancy?

A
  1. small frequent meals, q 1-2 hrs
  2. avoid spicy, high-fat, acidic, very sweet.
  3. Eat protein dominant, salty, low fat, bland, and/or dry foods
  4. drink fluids 30 mins prior or after to meals
  5. acupressure bands
  6. fresh ginger 250 mg q 6 hrs
  7. aromatherapy-p[eppermint, lemon, orange
  8. taking vitamins at night
  9. vitamin B6 - 10-25 mg TID
36
Q

Medications for NVP (nausea and vomiting in pregnancy)

A
37
Q
A

NURS 681A Antenatal and Gynecology for the Midwife (6 decks)

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