DISCOMFORT DURING PREGNANCY AND NURSING  Constipations

INTERVENTION - increase fluid intake, fiber in the diet, and exercise

- develop regular bowel habits
First Trimester
-use stool softeners as recommended by the
 Nausea and Vomiting physicians
-avoid odors  Backaches
-eat dry crackers or toast before arising in the morning -proper body mechanics
-have small but frequent meals -practice pelvic tilt exercise
-avoid greasy or highly seasoned foods -avoid uncomfortable working heights
-take dry meals with fluids bet. Meals -avoid high-heeled shoes
-drink carbonated beverages -avoid lifting heavy loads and fatigue
 Urinary Frequency  Leg Cramps
-void when urge is felt -practice dorsiflexion of feet in order to stretch
-increase fluid intake during the day affected muscles
-decrease fluid intake in the evening to decrease -evaluate diet
nocturia -apply heat to affected muscles
 Fatigue  Faintness
-plan time for a nap or rest periods daily -arise slowly from resting position
-go to bed earlier -avoid prolonged standing in warm or stuffy
-seek family support so that more time is available environment
to rest  Dyspnea
 Breast Tenderness -use proper posture when sitting or standing
-wear well-fitting, supportive bra -sleep propped up with pillows for relief if problem
 Leukorrhea occurs at night
-promote cleanliness by daily bathing  Flatulence
-avoid douching, nylon underpants, and pantyhose -avoid gas-forming foods
-use cotton pants -chew food thoroughly
 Nasal stuffiness -get daily regular exercise
-may be unresponsive, but cool air vaporizer may -maintain normal bowel habits
help
-avoid nasal sprays and decongestants 5 THEORIES OF LABOR

Second and Third trimester  PROGESTERONE DEPRIVATION THEORY

 Heartburn (pyrosis) - Progesterone – relaxes the uterine muscles
-eat small and more frequent meals - With decreased amounts, labor pains occur
-avoid overeating fatty and dried foots, lying down  UTERINE STRETCH THEORY
after eating -any hollow body organ will contract and
 Ankle Edema empty its content when stretched to its fullest
-practice dorsiflexion of feet when prolonged capacity
sitting or standing or standing is necessary
 OXYTOCIN THEORY
-elevate legs when sitting or resting
- Oxytocin makes the uterine muscles contract
-avoid tight garters or restrictive bands around
- The uterus becomes increasingly sensitive to
legs
oxytocin at about the 37th week of pregnancy
 Varicosities
-elevate legs frequently  PROSTAGLANDIN THEORY
-avoid crossing of legs at the knees, standing for - initiation of labor is said to result from the
long periods release of arachidonic acid which forms
 Hemorrhoids prostaglandin (PGE2) – responsible for uterine
-avoid constipation contractions
-apply icepacks, warm soaks, sitz bath; gently  THEORY OF AGING PLACENTA
reinsert rectum as necessary -because of the decreased blood supply, the
uterus contracts
 FETAL ASSESSMENT
 ATTITUDE-relationship of fetal parts to each
other
 LIE-relationship of the long axis of the fetus to
the long axis of the mother
 PRESENTATION-fetus’ body part that engages
in the true pelvis
a. Cephalic ( head ): vertex, brow, or face
b. Breech : complete, single or double footling
c. Shoulder : cannot be delivered vaginally
 POSITION
-relationship of presenting parts to the four
quadrants of the mother’s pelvis .
-Letters L and R are used for left or right.
-A and P for anterior and posterior;
-O for occiput;
-M for mentum or face;
-S for sacrum
 Vertex : occiput, LOA, LOP,ROA,ROP
 Face: chin (mentum) LMA,LMP,RMA,RMP
 Breech : sacrum, LSA,LSP,RSA ,RSP
DIFFERENCE BETWEEN TRUE AND FALSE
LABOR
 Contractions
True: Regular, increasing frequency, duration
& intensity
False: Irregular, no change in frequency,
duration & intensity
 Discomfort
True: At lumbo-sacral Intensified by walking
False: At hypogastrium Relieved by walking
LABOR WATCHING
 FREQUENCY – from the beginning of one
contraction to the beginning of the next
contraction
 DURATION – from the beginning of one
contraction to the end of that same
contraction
 INTENSITY – strength of contraction,
measured with fingertips lightly on the
fundus: Mild /Moderate / Strong
 REGULARITY – established pattern that
increases in frequency and duration
 EFFACEMENT – thinning of cervix 0 – 100%
 DILATATION – opening of the cervix 0 – 10
cms
STAGES OF LABOR
 1ST STAGE: STAGE OF DILATATION
-First true contractions to complete cervical
dilatation
 2ND STAGE: STAGE OF EXPULSION
-Complete dilatation to delivery of fetus
 3RD STAGE: PLACENTAL STAGE-
-Delivery of infant to delivery of the placenta
 4TH STAGE: STAGE OF IMMEDIATE
RECOVERY
- 1st hour following delivery of the placenta

 Cervix
True: Effaced & dilated
False: Closed, no change

 Show
True: Present
False: Absent

 Effect of sedative
True: Discomfort not relieved by sedation
False: discomfort relieved by sedation