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PREGNANCY PREGNANCY DISCOMFORTS and DISCOMFORTS and
INTERVENTIONSINTERVENTIONS
Ma. Khatrina CapatiMa. Khatrina Capati
Norlyn Marrie ViloriaNorlyn Marrie Viloria
The common discomforts The common discomforts of pregnancy result from of pregnancy result from
physical and anatomic physical and anatomic changes and are fairly changes and are fairly specific to each of the specific to each of the
three trimesters.three trimesters.
First TrimesterFirst TrimesterThe 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 TendernessInfluencing Factor:• Increased levels of estrogen
and progesterone
Intervention:• Wear well-fitting,
supportive bra (wide shoulder strap)
5. Increased Vaginal DischargeInfluencing 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 NosebleedInfluencing Factor:• Elevated estrogen levelsIntervention:• May be unresponsive, but
cool-air vaporizer may help; avoid use of nasal sprays and decongestants.
7. Ptyalism
Influencing Factor:• Specific causative factors
unknownIntervention:• 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. HeartburnInfluencing 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 EdemaInfluencing 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 VeinsInfluencing Factors:• Venous congestion in the
lower veins that increases with pregnancy• Hereditary factors (weakening
of walls of veins, faulty valves)• Increased age and weight gain
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. ConstipationInfluencing 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. BackacheInfluencing 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 CrampsInfluencing Factors:• Imbalance of calcium/phosphorus
ratio• Increased pressure of uterus on
nerves• Fatigue• Poor circulation to lower extremities• Pointing the toes
Interventions:• Practice dorsiflexion to feet to
stretch affected muscle.• Evaluate diet.• Apply heat to affected
muscles.• Arise slowly from resting
position.
15. FaintnessInfluencing 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. DyspneaInfluencing 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 SyndromeInfluencing 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 SyndromeInfluencing 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.