03.02 Discomforts of Pregnancy

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  1. Pregnancy can cause many different discomforts
  2. Every pregnancy is different and dynamic, therefore one cannot predict the severity of various potential discomforts or which ones they will experience

Nursing Points

  1. Most discomforts are caused by the expanding uterus and pelvis, hormonal changes and increased blood volume
    1. Generalized discomforts
      1. Syncope
      2. Fatigue
      3. Headache
      4. Backache
      5. Nausea
      6. Nasal congestion
      7. Weight gain
      8. Generalized edema
      9. Round ligament pain
      10. Diastasis recti
      11. Generalized itching
      12. Gait changes (widening standing stance to improve balance)
    2. Genitourinary / female reproductive discomforts
      1. Urinary urgency and frequency
      2. Vaginal discharge increases
      3. Breast tenderness increases
      4. Increase in yeast infections
    3. Cardiovascular discomforts
      1. Varicose veins
      2. Edema mostly in feet and ankles
        1. Carpal tunnel
      3. Leg cramps
      4. Shortness of breath
      5. Nasal stuffiness
    4. Gastrointestinal discomforts
      1. Nausea and vomiting
      2. Constipation
      3. Hemorrhoids
      4. Heartburn

Therapeutic Management

  1. Elevate legs/feet for edema
  2. Over the counter antacids for heartburn
  3. Mostly managed with OTC meds or home remedies

Patient Education

  1. How to symptom manage with home remedies
  2. Medication
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In this lesson I will go over the discomforts of pregnancy and what is causing them.

Many discomforts can occur to the entire body. It is all effected. Everyone will experience different things because each pregnancy is different. Some will have more severe symptoms where others have non. Or some with have a horrible uncomfortable first pregnancy and the next pregnancy not as bad. The expanding uterus and changes to the pelvis are reasons for some discomforts. Hormonal changes are a big cause as well as increased blood volume.
Some generalized discomforts are Syncope, fatigue, headache, backache, nausea, nasal congestion, weight gain, generalized edema, round ligament pain, diastasis recti, generalized itching, gait changes. Gait changes occur because of a widening standing stance to improve balance and the relaxin hormone which causes everything to stretch out. With the female and genitourinary system there are changes as well. There is more urinary frequency. It can be hard because women can not always fully empty their bladder because of the uterine pressure. We have to worry about UTIs for these patients. Women have an increase in vaginal discharge. There is more moisture so yeast infections occur. Breast tenderness increases as well. With cardiovascular discomforts, blood pressure lowers which can cause syncope and lightheadedness. Varicose veins because of the abdominal weight constricting blood flow and new veins form. Edema mostly in feet and ankles occur but tere can also be swelling in the hands which can cause carpal tunnel. leg cramps shortness of breath are other discomforts. Nasal stuffiness is caused by estrogen increasing constriction causing the swelling and stuffiness in the nasal cavity. Gastrointestinal discomforts occurs because everything slows down, this is caused by progesterone. This will cause nausea and vomiting, constipation, heartburn and hemorrhoids because of the weight but also from straining
Elevate legs/feet for edema and over the counter medications like Ranitidine or zantac can help with heartburn discomforts. Stool softeners can also be given to help with constipation. Diet can also assist with this. More fruits and veggies to increase fiber. Small frequent meals and eating crackers before rising cna help with nausea.
Symptom management is a lot of over the counter medications to ease with heartburn, and constipation. Diet is very helpful to include in education. We need the patient to eat small frequent meals to help keep her stomach from being empty. Remember an empty stomach can lead to bad nausea. Ginger supplements have been found to aid with nausea and can be taken over the counter as well. If patients are having difficulty with lightheadedness then they should be taught to rise slowly. Don’t just jump out of bed in the morning. If they are having difficulty with varicose veins and leg pain then compression hose might be a good option for these patients. Patients should get good rest when they can and listen to their bodies. For medication education, we need the patient to know that not all over the counter medications are safe and give a list of safe medications for the patient.

Comfort, reproduction and hormonal Regulation are our concepts. We want to keep the patient comfortable if we can. Reproduction and hormones have caused the discomfort.
To review hormones are in charge. Those hormones are progesterone, estrogen, aldosterone, HCG are the main hormones involved. The entire body is involved and affected. Fetal growth in the growing uterus can cause a lot of these discomforts as well.

Make sure you check out the resources and videos that have been attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing.

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