COMMON DISCOMFORTS OF PREGNANCY

AND ITS MANAGEMENT

NAUSEA AND VOMITING(MORNING SICKNESS)
CAUSES MANAGEMENT
• Sensitivity to Increase • Take crackers or bread in
HCG the morning
• Can also be adjustment to • Avoid fatty,spicy food
increase estrogen or ,acidic and citrus fruits on
progesterone levels an empty stomach
• Pressure and • Take small frequent meals
displacement of the GIT • Take fluids between meals
• Diminished gastric • Encourage to keep in an
motility upright position after
• Emotional disturbance; meals to avoid reflux.
fatigue
 DYSPNEA
DYSPNEA
• shortness of breath and lung
compression due to pressure on
the diaphragm by the expanding
uterus
MANAGEMENT
• Semi-fowler’s position; Sleep on
additional pillows
• Avoid supine position
• Wear loose clothes and bra
• Frequent rest periods
• Maintain good posture.
• Avoid overeating.
• Stop smoking.
• Limit activity before becoming
dyspneic.
• Report increasing dyspnea with
minimal activity
 FATIGUE
FATIGUE MANAGEMENT

• extreme tiredness • Adequate rest and

and exhaustion sleep
because of increased • Avoid prolonged
metabolic standing
requirements. • Practice good body
mechanics(posture)
• Report increase
fatigue with regular
activities-a danger
sign of heart disease
 BREAST TENDERNESS
BREAST TENDERNESS MANAGEMENT:

• Feeling of fullness and • encourage to wear a

occasional pain due to bra with a wide
increasing hormones shoulder strap for
of pregnancy support
• one of the first • dress warmly
symptoms that the • Get examined if with
woman would notice intense pain, presence
in early pregnancy. of nipple fissures or
• Tenderness varies breast abscess
between women;
some hardly notice the
sensation at all.
 HEARTBURN / PYROSIS
HEARTBURN
• Burning sensation along the
esophagus caused by
regurgitation of gastric contents
into the lower esophagus.
CAUSES
• Poor tone of the cardiac
sphincter of the stomach
• regurgitation of gastric contents
into the lower esophagus
• Decreased peristalsis and gastric
motility that slows gastric
emptying
• pressure of the expanding
uterus
 MANAGEMENT

• Eat slowly, small frequent meals rather than large meals

• Sleep on the left side with two pillows
• Avoid indigestible, fatty, spicy foods, coffee, carbonated beverages,
citrus juices , gas-forming foods
• Take meals in an upright position
• Do not lie down immediately after eating(try and wait at least 2 hours.
• Medication maybe taken as long as prescribed by the doctor.
• Be certain a woman understands that this “chest” pain is from her
gastrointestinal tract and that, although it is called heartburn, it has
nothing to do with her heart.
 SUPINE HYPOTENSION
(INFERIOR VENA CAVA SYNDROME)
SUPINE
SYMPTOMS
HYPOTENSION
• occurs when a • Nausea
woman lies supine • lightheadedness
and uterus presses • cold and clammy
on the inferior vena skin
cava, impairing
• Faintness
blood return to the
heart • Hypotension (low
blood pressure)
• Palpitations,
irregular heart rate
 MANAGEMENT

• Gradual positional changes

• Rising slowly and avoiding
extended periods of standing
• Avoid supine position in 2nd -
3rd trimester; always rest or
sleep on their side, not their
back.
• Use the left side-lying position
(the left lateral
recumbent(LLR)
 HEART PALPITATIONS
PALPITATIONS
• bounding palpitation of the
heart experienced by the
woman upon sudden
movement
• due to circulatory
adjustments necessary to
accommodate increased
blood supply during
pregnancy.
MANAGEMENT
• Advise the woman to move
in slow, gradual
movements to prevent
heart palpitations.
• Reassure woman that
palpitations are normal and
to be expected occasionally
only
• If palpitations occur very
frequently or continuously
and accompanied by pain
should be reported to a
physician
 CONSTIPATION

• Slowed peristalsis
• Pressure on bowels
exerted by the growing
Causes: uterus
• Decreased physical
exercise
• Oral iron intake
 MANAGEMENT FOR CONSTIPATION

• Increase fluid intake

• Increase fiber/roughage in the diet
• Observe daily/regular bowel movement
• Regular exercise(walking)
• deep breathing and relaxation techniques.
• Enema is avoided
• Iron supplements need not be stopped because it helps build up fetal
iron stores.
• Take iron with juice for better absorption
• For FLATULENCE- eat small frequent meals and avoid gas forming food.
• Over-the-counter laxatives are contraindicated unless prescribed.
 PALMAR ERYTHEMA
PALMAR
MANAGEMENT
ERYTHEMA

• Palmar • Explain that this

prutitus is normal and
once adjusted to
• Redness and the increased
itchiness of level of estrogen,
the palms the erythema
• Due to and pruritus
increased disappear.
estrogen level. • Calamine lotion
to soothe the
itchiness
 URINARY FREQUENCY AND URGENCY
CAUSES
• Pressure on the bladder by
the growing uterus in the 1st
and 3rd trimesters(after
lightening)
• Fluid retention due to
increase blood volume
MANAGEMENT
• Increase daytime fluid intake to
replace losses
• Advise woman that there should be
No fluid restriction
• Use perineal pad to absorb leakage
• Frequent flushing: ‘front to back”
• Reduce caffeine intake
• Use KEGEL EXERCISE
• Report burning sensation ,dysuria,
cloudy urine or tea-colored urine
 KEGEL EXERCISE

• alternately contracting
and relaxing perineal
muscles helps
strengthen urinary
control, directly
strengthens perineal
muscles for birth, and
decreases the possibility
of stress incontinence
 LEUKORRHEA
LEUKORRHEA MANAGEMENT
• daily bath; maintain good
• a whitish, hygiene
mucoid, non- • Flush perineum after voiding
• Wear cotton undergarments
foul normal • Use perineal pads and change
vaginal frequently.
• Avoid tight underpants
discharge due • Advise women to contact
to high estrogen their physician if there is a
change in the color, odor, or
character of this discharge as
these suggest infection.
 HEMORRHOIDS
HEMORRHOIDS CAUSES

• varicosities of • Constipation
the rectal • Pressure on
veins the rectal
• a swollen veins by the
veins in the weight of the
anal region uterus
 PREVENTION OF
HEMORRHOIDS
• Daily bowel evacuation to
relieve constipation
• Avoid straining during
bowel movement
• Avoid lifting heavy objects
MANAGEMENT
• Avoid spicy foods
• Increase fluids
• High fiber diet
• Exercise regularly
• Warm water sitz bath
• stool softener
• Prolapsed hemorrhoids are
lubricated and maybe push
back gently
 BACKACHE
CAUSES
• changes in the center of gravity from
the enlarging abdomen and breasts.
• Faulty posture, fatigue
• Prolonged standing/sitting
• Strain from an increased lumbar
curve(lordosis)
PREVENTION
• Maintain good posture
• Lift objects by holding them close to the
body
• Squat rather than bend over to pick up
objects
• Wear flat or low-heeled and well-fitting
shoes
• Sleep on firm mattress or backboard.
• Use of small pillow placed along the
lumbar curve
• Wear maternity girdle as recommended
• Pelvic rock exercise and tailor sitting
 PELVIC ROCKING EXERCISE
https://www.youtube.com/watch?v=moa4h-rjuNE
 TAILOR SITTING
https://www.youtube.com/watch?v=v2ga0gHgd-k
 LEG/MUSCLE CRAMPS
MUSCLE CRAMPS CAUSES
• Calcium and phosphorous
• sudden and involuntary imbalance(decreased serum calcium
contraction of one or levels, increased phosphorus levels)
more muscles. • interference with circulation
• Muscle fatigue and tense body
posture.
 INTERVENTIONS
MANAGEMENT DURING MUSCLE
CRAMPS
• Avoid fatigue and cold • Dorsiflex the foot and
legs. extend the leg
• Increase dietary intake • Press the back of
of calcium knee( popliteal area
• Avoid prolonged against the bed and
standing and sitting point the toes of the
• Change positions affected leg toward
frequently knees
• Elevate legs frequently
• No constricting garters
 LEG VARICOSITIES
VARICOSITIES CAUSES

• Tortuous(twisted • weight of the

and dilated) distended uterus
veins caused by the puts pressure on
pressure of the the veins returning
uterus to veins at blood from the
the lower lower extremities.
extremities. • Constricting garters
• Enlargement of the • Prolonged standing
lumen of a vein due and sitting
to thinning and
stretching of its
walls.
 MANAGEMENT FOR LEG VARICOSITIES

• Avoid prolonged standing

• Avoid sitting with legs crossed or knees bent
• Avoid constrictive clothing(wearing round garters and knee-high
stockings.
• Avoid constipation and bearing down.
• Perform moderate exercise( walking)
• Elevate legs and hips frequently:
• Use elastic support stockings
• Take vitamin C for the fomation of blood vessel collagen and
endothelium.
 ANKLE EDEMA
ANKLE EDEMA CAUSES

• swelling of the • general fluid

ankles and feet retention
most noticeable • reduced blood
at the end of the circulation in the
day lower
• common in late extremities
pregnancy because of
uterine pressure
 MANAGEMENT

• Avoid prolonged standing or sitting.

• Elevate legs frequently
• Adequate rest and exercise
• Wear comfortable shoes
• Avoid constrictive clothing (garters, knee-high stockings) that
impede lower extremity circulation
• Drink at least eight glasses of fluid for "natural" diuretic effect.
• Report swelling/edema of hands and face and Assess if the
woman has hypertension or proteinuria(protein in the urine) to
rule out eclampsia.
 CRAVINGS FOR FOOD
CRAVINGS FOR FOOD
• aversions to certain foods
during pregnancy
• Due to physiologic need for
more carbohydrates or
particular vitamins and
minerals
• allows for more calories and a
greater pregnancy weight
gain
MANAGEMENT
• Nutrition history- ask if a
woman notices any particular
cravings. As long as this is a
healthy type of food, help her
plan a nutrition intake that
includes the food, at least in
moderation
 PICA MANAGEMENT
• Abnormal craving for non food • Ingestion may cause harm and
substances can leave a woman deficient of
• Example: Laundry starch,clay, protein, iron, calcium and
dirt,chalk nutrients essential for healthy
• Results to iron deficiency pregnancy outcome
anemia • often accompanies iron
deficiency anemia, correcting
this underlying problem with
an IRON SUPPLEMENT may
correct the pica.
• Refer for further assessment
 References
❖Pillitteri, Adele. Maternal and Child Health Nursing, Care
of the Childbearing & Childrearing Family. 7th Edition.
Copyright 2014. Lippincott William and Wilkins
❖Murray, Sharon Smith. Foundations of Maternal-Newborn
Women’s Health Nursing 6th Edition. Copyright
2014.Elsevier(Singapore)
❖Salustiano,Rosalinda Parado. Essential Procedures for
Safe Maternity Care. 3rd Edition. Copyright 2011 C&E
Publishing, Inc.
HAVE FUN IN
LEARNING!
KEEP SAFE &
GODBLESS