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The Expectant Family . Chapter 11. Common Discomforts of Pregnancy. Constipation Nausea/Vomiting Rest Urinary frequency Breast tenderness Fatigue Increased vaginal discharge. Anticipatory Guidance. Involve father in PNC What to expect Encourage to attend classes

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The Expectant Family

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The expectant family l.jpg

The Expectant Family

Chapter 11


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Common Discomforts of Pregnancy

  • Constipation

  • Nausea/Vomiting

  • Rest

  • Urinary frequency

  • Breast tenderness

  • Fatigue

  • Increased vaginal discharge


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Anticipatory Guidance

  • Involve father in PNC

  • What to expect

  • Encourage to attend classes

  • Assess family unit i.e. siblings


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Relief of Common Discomforts

  • Morning sickness-cause by increase in hCG

  • Small frequent meals, avoid lying, take OTC meds

  • Assess for S/S of dehydration

  • Urinary frequency

  • Report burning, urgency, pain, and blood

  • Intake= 2000 cc /day. Do not decrease fluid intake


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Relief of Common Discomforts

  • Fatigue- presumptive, difficult to rest and sleep

  • Breast tenderness- increase in estrogen and progesterone

  • Leukorrhea- hyperplasia of vaginal discharge.

  • Epitaxis and nasal stuffiness- increase estrogen.

  • NI- use vaporizer, no meds

  • Ptyalism- bitter saliva


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Second and Third Trimester

  • Pyrosis- heartburn

  • Causes – progesterone, decrease in gastric motility, relaxation of cardiac sphincter

  • Use low sodium antacids

  • Ankle edema-slow venous return

  • Avoid prolonged sitting, standing, hot weather

  • Assess for proteinuiria and hypertension


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Second and Third Trimester

  • Varicosities-weak vein wall or incompetent valves.

  • Wear support stocking, avoid standing and sitting

  • Hemorrhoids-varicosities of rectal vein

  • DO NOT STRAIN

  • Constipation- caused by progesterone, iron, fetal growth, displacement of intestines.

  • Give stool softeners


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Second and Third Trimester

  • Dyspnea-pressure on diaphragm

  • Primigravida experience lightening (few weeks)

  • Round ligament pain

  • Carpal tunnel- pressure on median nerve

  • Provide anticipatory guidance


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Self Care

  • Monitor fetal movement

  • Breast care- supportive bra and nipple preparation

  • Clothing- not too tight

  • Bathing- avoid hot water, slippery surfaces

  • Working

  • Avoid travel if high risk

  • Balance rest and exercise


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Exercises

  • Pelvic tilt- press back to floor

  • Abdominal exercise

  • Kegel- lift perineal muscles

  • Prevents urinary (cystocele) and fecal (rectocele) incontinence


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Sexual Activity

  • Avoid if high risk

  • Openly discuss feelings

  • Explore other forms of intimacy


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Teratogens

  • Avoid medications in first trimester

  • Cat. A- no fetal risk

  • Cat B- human studies support use- low risk

  • Cat C- no adequate studies or risk to animals

  • Cat D- harmful but benefits must outweigh risks

  • Cat. X


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Teratogens

  • Tobacco- associated LBW, PTL

  • Alcohol- FAS

  • Caffeine- use in moderation

  • Marijuana- r/t poly substance abuse

  • Cocaine- abruption, SGA, fetal distress, withdrawal


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“Older” Couples

  • Over 35

  • Better educated and financially stable

  • Risks r/t preexisting conditions

  • PIH, GDM, genetic abnormalities

  • May be more assertive with provider

  • Screening-MFSAP, estriol, hCG, amniocentesis


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