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Anticipatory Guidance During Pregnancy PowerPoint PPT Presentation


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Anticipatory Guidance During Pregnancy. By Catherine Ramos Marin, MSN/ Ed(c ), WHCNP, RN. First Trimester (1-13 weeks). Discomforts of pregnancy (N/V, frequent urination) Increase sleep needs (8 hrs./day) Exercise (fine as long as the client is able to converse easily whle exercising) - PowerPoint PPT Presentation

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Anticipatory Guidance During Pregnancy

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Anticipatory guidance during pregnancy l.jpg

Anticipatory Guidance During Pregnancy

By

Catherine Ramos Marin, MSN/Ed(c), WHCNP, RN


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First Trimester (1-13 weeks)

  • Discomforts of pregnancy (N/V, frequent urination)

  • Increase sleep needs (8 hrs./day)

  • Exercise (fine as long as the client is able to converse easily whle exercising)

  • Work: no exposure to hazardous chemicals or toxins

  • Ingest no medication, no alcohol/drugs and to stop smoking


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Second Trimester (14-26 weeks)

  • Sexual needs and desire: encourage communication b/w husband and wife

  • Regular dental check-up: maintain dental hygiene, delay radiographs and major dental work if possible (gum hypertrophy is common)


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Third Trimester (27 weeks to 40 weeks)

  • Schedule childbirth classes

  • Increase urinary frequency and dyspnea

  • Review interventions on leg cramps, nasal stuffiness, varicose veins, and constipation

  • Breastfeeding teachings

  • Choosing pediatrician and clinic

  • Nutritional needs: period of rapid fetal growth

  • Teach s/s of preterm labor

  • Teach danger signs of pre-eclampsia and eclampsia


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Nutritional Teachings

  • Increase intake by 300 calories above basal and activity needs

  • Increase protein by 30 gm/day

  • Increase intake of Iron (30+ mg) and folic acid (800 to 1000 mcg) through diet and supplements

  • Increase intake of Vitamin A, Vit. C and calcium through diet


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Weight Gain

  • 2-4 lbs. in the 1st trimester is considered normal

  • 0.9 lb./week thereafter

  • Is normal (> 2 lbs/week may be related to pre-eclampsia: edema

  • Total weight gain during pregnancy: 25-35 lbs.


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Substance Abuse During Pregnancy

  • Smoking: low birth weight infant

  • Alcohol: fetal alcohol syndrome

  • Cocaine: preterm labor and abruptio placenta

  • Teach that teratogenic fetal effects are highest in the first trimester


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Anemia during Pregnancy

  • A decrease in the oxygen carrying capacity of blood

  • Often related to Iron deficiency and reduced dietary intake

  • Occurs in 20% of pregnant women

  • Associated with increase incidence of abortion, PTL, pre-eclampsia


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Anemia

  • Hgb < 11 g/dl, Hct < 37 % during 1st trimester

  • Hgb <10.5 g/dl, Hct < 35% during 2nd trimester

  • Hgb <10 g/dl, Hct < 32% during 3rd trimester


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Nursing Interventions

  • 24 hr. dietary recall

  • Oral administration of Iron

  • Teach nutritional requirements


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Oral Administration of Iron

  • Best absorbed on an empty stomach

  • Taken with Vit. C such as OJ to increase absorption

  • Take in the evening if problem exist w/ morning sickness

  • Stools will turn dark green to black

  • Lab values should be checked for increased reticulocytes and rising Hgb and Hct


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Teenage Adolescent Pregnancy

  • Pregnancy at age 19 or younger

  • Highly associated with anemia, pre-eclampsia, CPD, STDs, IUGR, and ineffective parenting

  • Assess: Nutritional status (24 hr. diet recall), attitude toward pregnancy and becoming a mother, social support system (family, spouse, BF, friends), domestic violence, peer activities (smoking, drugs, alcohol), economic status, educational status, access to prenatal care