Pregnancy Discomforts And Interventions

PREGNANCY DISCOMFORTS and INTERVENTIONS Ma. Khatrina Capati Norlyn Marrie Viloria

The common discomforts of pregnancy result from physical and anatomic changes and are fairly specific to each of the three trimesters.

First Trimester The dramatic hormonal changes of the first trimester account for many of the discomforts experienced in this period. These discomforts tend to subside by the beginning of the fourth month of pregnancy.

1. Nausea and Vomiting Influencing Factors: • Increased levels of HCG • Changes in CHO metabolism • Emotional factors • Fatigue

Interventions: • Avoid odors or causative factors. • Eat dry crackers or toast before arising in morning. • Have small but frequent meals. • Avoid greasy or highly seasoned foods. • Take dry meals with fluids between meals. • Drink carbonated beverages.

2. Urinary Frequency Influencing Factor: • Pressure of uterus on bladder in both first and third trimesters

Interventions: • Void when urge is felt. • Increase fluid intake during the day. • Decrease fluid intake only in the evening to decrease nocturia.

3. Fatigue Influencing Factors: • Specific causative factors unknown • May be aggravated by nocturia due to urinary frequency

Interventions: • Plan time for nap or rest period daily. • Go to bed earlier. • Seek family support and assistance with responsibilities so that more time is available to rest.

4. Breast Tenderness

Influencing Factor: • Increased levels of estrogen and progesterone Intervention: • Wear well-fitting, supportive bra (wide shoulder strap)

5. Increased Vaginal Discharge Influencing Factor: • Hyperplasia of vaginal mucosa and increased production of mucus by the endocervical glands due to the increase in estrogen levels

Interventions: • Promote cleanliness by daily bathing. • Avoid douching, nylon underpants, and pantyhose; cotton underpants are more absorbent; powder can be used to maintain dryness if not allowed to cake.

6. Nasal Stuffiness and Nosebleed Influencing Factor: • Elevated estrogen levels Intervention: • May be unresponsive, but cool-air vaporizer may help; avoid use of nasal sprays and decongestants.

7. Ptyalism Influencing Factor: • Specific causative factors unknown Intervention: • Use astringent mouthwashes, chew gum, or suck hard candy

Second and Third Trimesters It is more difficult to classify discomforts as specifically occurring in the second or third trimesters because may problems represent individual variations in women.

8. Heartburn Influencing Factor: • Increased production of progesterone, decreasing gastrointestinal motility and increasing relaxation of cardiac sphincter, displacement of stomach by enlarging uterus, thus regurgitation of acidic gastric contents into the esophagus

Interventions: • Eat small and more frequent meals. • Use low-sodium antacids. • Avoid overeating, fatty and fried foods, lying down after eating, and sodium bicarbonate.

9. Ankle Edema Influencing Factors: • Prolonged standing or sitting • Increased levels of sodium due to hormonal influences • Circulatory congestion of lower extremities • Increased capillary permeability • Varicose veins

Interventions: • Practice frequent dorsiflexion of feet when prolonged sitting or standing is necessary. • Elevate legs when sitting or resting. • Avoid tight garters or restrictive bands around legs.

10. Varicose Veins Influencing Factors: • Venous congestion in the lower veins that increases with pregnancy • Hereditary factors (weakening of walls of veins, faulty valves) • Increased age and weight

Interventions: • Elevate legs frequently. • Wear supportive hose. • Avoid crossing legs at the knees, standing for long periods, garters, and hosiery with constrictive bands.

11. Hemmorhoids Influencing Factors: • Constipation • Increased pressure from gravid uterus on hemorrhoidal veins

Interventions: • Avoid constipation. • Apply ice packs, topical ointment, anesthetic agents, warm soaks, or sitz baths; gently reinsert into rectum as necessary.

12. Constipation Influencing Factors: • Increased levels of progesterone, which cause general bowel sluggishness • Pressure of enlarging uterus on intestine • Iron supplements • Diet, lack of exercise, and decreased fluids

Interventions: • Increase fluid intake, fiber in the diet, and exercise. • Develop regular bowel habits. • Use stool softeners as recommended by physician.

13. Backache Influencing Factors: • Increased curvature of the lumbosacral vertebrae as the uterus enlarges • Increased levels of hormones, which cause softening of cartilage in body joints • Fatigue • Poor body mechanics

Interventions: • Use proper body mechanics. • Practice the pelvic-tilt exercise. • Avoid uncomfortable working heights, high-heeled shoes, lifting heavy loads, and fatigue.

14. Leg Cramps Influencing Factors: • Imbalance of calcium/phosphorus ratio • Increased pressure of uterus on nerves • Fatigue • Poor circulation to lower extremities

Interventions: • Practice dorsiflexion to feet to stretch affected muscle. • Evaluate diet. • Apply heat to affected muscles. • Arise slowly from resting position.

15. Faintness Influencing Factors: • Postural hypotension • Sudden change of position causing venous pooling in dependent veins • Standing for long periods in warm area • Anemia

Interventions: • Avoid prolonged standing in warm or stuffy environments. • Evaluate hematocrit and hemoglobin.

16. Dyspnea Influencing Factor: • Decreased vital capacity from pressure of enlarging uterus on the diaphragm Interventions: • Use proper posture when sitting and standing. • Sleep propped up with pillows for relief if problem occurs at night.

17. Flatulence Influencing Factors: • Decreased gastrointestinal motility leading to delayed emptying time • Pressure of growing uterus on large intestine • Air swallowing

Interventions: • Avoid gas-forming foods. • Chew food thoroughly. • Get regular daily exercise. • Maintain normal bowel habits.

18. Carpal Tunnel Syndrome Influencing Factors: • Compression of median nerve in carpal tunnel of wrist • Aggravated by repetitive hand movements

Interventions: • Avoid aggravating hand movements. • Use splint as prescribed. • Elevate affected arm.

19. Round Ligament Syndrome Influencing Factors: • Enlargement of the uterus causing round ligaments stretch and hypertrophy as the uterus rises up in the abdomen. Intervention: • Applying heat pad brings relief.