DISCOMFORTS DURING PREGNANCY
A. EARLY PREGNANCY
DISCOMFORT
1. Breast tenderness
2. Palmar erythema
Due to increase estrogen
3. Constipation
4. Nausea and vomiting
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SOLUTION/MANAGEMENT
● Wear bra with a wide shoulder strap for
support
● Dress calmly to avoid cold drafts if cold
increases symptoms.
● Calamine lotion
● Encourage her toe evacuate her bowels
regularly
● Increase fiber in her diet by eating raw fruits,
bran and vegetables
● Increase fluid intake at least 8nox glasses of
water daily
● Encourage daily exercise such as walking
● Should not use mineral oil ( absorb fat soluble
vitamins ADEK= vitamins necessary for fetal
and maternal health)
● Avoid enema = can initiate labor
● Avoid over the counter laxatives
● Use stool softener = docusate sodium (Colace),
evacuation suppositories like glycerin
● Avoid gas forming foods ( cabbage, beans)
● Eat a few dry crackers, toast or a sourball
before getting out of bed in the morning to
increase carbohydrate intake.
● Eat small but frequent meals rather than large
infrequent ones.
● Avoid greasy or highly seasoned food
● Delay breakfast until nausea passes
● Make up missed meals at some other time of
the day to maintain nutrition
● Avoid sudden movements and fatigue because
these may increase or cause nausea.
● Eat a snack before bedtime so delaying
breakfast will not cause you to go a long time
between meals.
● Purchase a wrist acupressure band= for
motion sickness.
 ● Teach the woman the importance of nutrition
for herself and fetus
✔ 7 servings of CHON rich food, 1 serving
of vegetable protein
✔ 3 servings of dairy products or other
calcium rich foods.
✔ 7 servings of grain products
✔ 2 or more servings of vit C rich
vegetables or fruit.
✔ 3 servings of other fruits and
vegetables
✔ 3 servings of unsaturated fats
✔ 2 or more servings of other fruits and
vegetables

If nausea is present:
● Try sipping a carbonated beverage, water or an
herbal noncaffeinated or ginger tea.
● Try a walk outside in the fresh air or take deep
breaths through an open window.

Notify your health care provider if:

● You are losing weight rather than gaining
weight
About 2-5lb gain in early pregnancy (.9 – 2.3
kg) and about 1 lb ( .5 kg)/ week for the
remainder of the gestation.
● You are unable to make up for lost meals some
time of the day.
● Ve signs of dehydration such as little urine
output.
● Nausea has lasted past 12 weeks of pregnancy
● Vomit more than once daily
Heartburn (pyrosis) ● Eat small meals frequently rather than large
meals
● Sleep on left side with 2 pillows to elevate the
upper torso.
● Do not lie down immediately after eating; try
and wait at least 2 hours.
● Avoid fatty and fried foods, coffee, carbonated
beverages, tomato products, and citrus juices.
● Aluminum hydroxide (Amphogel, Alternagel) or
Maalox can be prescribe.
● Cimetidine (Tagamet) and ranitidine ( Zantac)
histamine antagonist

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5. Muscle cramps
● Due to decreased serum calcium and
increased phosphorus
6. Hypotension
● Occurs when a woman lies on her back
and the uterus presses the vena cava
impairing blood return to the heart..
● Irregular heart beat
● Feeling of apprehension
7. Varicosities
● Or tortuous leg
Common during pregnancy because of the
weight of the distended uterus putting
pressure on the veins returning blood from the
lower estremities.= pooling of blood and
distended veins = veins engorges, inflamed and
painful.
8. Hemorrhoids ( varicosities of the rectal veins)
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● Chest pain should be due to
gastrointestinal tract reflux not related
to the heart.
● Lies on her back momentarily and extends her
involved leg while keeping her knee straight
and dorsiflexing the foot until pain disappears.
If with frequent leg cramps
● Take magnesium citrate or aluminum
hydroxide gel ( Amphogel) = binds
phosphorus in the intestinal tract and
lowers its circulating level.
● Lower milk intake to only 1 pint daily and
supplement it with calcium lactate to
reduce phosphorus level.
● Elevate lower extremities frequently
during the day to improve circulation.
● Avoid full leg extension .
● Rest or sleep on their side not on their back
● Rise slowly
● Avoid extended periods of standing
● If feeling to faint = sitting with her head
lowered.
● Rest in Sim’s position or on back with the legs
raised against the wall ( small firm pillow
placed under her right hip).
● Elevate legs using a footstool 15 to 20 minutes
2x a day.
● Instruct women to avoid crossing their legs or
knees bent
● avoid constrictive knee-high hose or garters
with varicosities:
● may need to use elastic support stockings
before rising in the morning= should reach
the point of distention.
● Exercise
● Break during long periods /.walk break at
least 2x a day
● Vitamin C helpful in reducing the size of
varicosities because it is helpful for the
formation of blood vessel collagen and
endothelium.
● Include fresh fruit or juice everyday.
● Daily bowel evacuation
● Modified sim’s position daily
 ● Because of the pressure on the veins from the
bulk of the growing uterus
9. Heart palpitatations
● Due to sudden turning over in bed,
movement
● Because of circulatory adjustments
necessary to accommodate her
increased blood supply during her
pregnancy
10. Frequent urination
● Bec of the pressure of the growing
uterus on the anterior bladder.
● Last for 3 months,
● disappear in the midpregnancy when
the uterus rises above the bladder
● return in late pregnancy= as the fetal
head presses against the bladder
11. abdominal discomfort
● experience by woman with multiple
pregnancy
12. Leukorrhea
● Whitish viscous vaginal discharges
● Increase in the amount of normal
vaginal secretions
● Occurs in response to high estrogen
levels and the increased blood supply
to the vaginal epithelium and cervix in
pregnancy.
B. MIDDLE TO LATE PREGNANCY
Discomforts
1. Backache
● Due to posture changes
● Can be a sign of a bladder or a kidney
infection
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● Knee chest position for 10-15 minutes to
reduce the pressure on rectal veins.
● Stool softener ( colace)
● Apply hazel or cold compress to external
hemorrhoids
● Gentle pressure to the hemorrhoids
● Slow movements
● If occur frequently accompanied with pain –
report it to a physician
● reduce caffeine
● kegel exercise for 3 sec 10x a day
● may take 6 weeks for the
pubococcygeal muscles to be
strengthened
● should not restrict fluid intake
● rise slowly from lying to a sitting or from a
sitting to a standing position.
● Daily bath or shower
● Wearing cotton underpants
● Sleeping without underwear
● Wear perineal pad
● Avoid tampons= because this would lead to
stasis of secretions and subsequent infection.
● Instruct woman to contact physician if there is
a change in color, odor, character.
● Avoid tight pants and pantyhose
Management
● Wear low heeled shoes
● Encourage woman to walk with her pelvis
tilted forward
● Apply local heat
● Squat rather than bend over to pick up
objects
● Lift objects close to the body
● Firm mattress should be used

2. Headache
● Due to expanding blood volume
which puts pressure on cerebral
arteries
3. Dyspnea
● Bec of the expanding uterus places
pressure on the diaphragm, lung
compression.
● Notices during night when she lies
flat
4. Ankle edema
● During late pregnancy
● Observe when the woman can’t
already wear their shoes
● Caused by fluid retention and
reduced blood circulation in the
lower extremities bec of uterine
pressure.
5. Braxton hicks contractions
● In early 8th-12th weeks of
pregnancy
● Middle or late= contractions
become stronger, pain like to a
menstrual cramp.
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● Pelvic rocking or tilting
● Acetaminophen (Tylenol)
● Acupuncture
● Caution women not to take herbal medicines,
muscle relaxants or analgesics without
consultation.
● Place cold towels on the forehead
● Take usual doses of acetaminophen
● If headache is more intense=report to a
physician= sign of PIH
● Sleep with head and chest elevated
● Use or more 2 pillows
● Limit her activities to prevent exertional
dyspnea.
● Resting in a left side lying position= bec this
increases the kidney’s glomerular filtration
rate and allows good venous return.
● Sitting for half an hour in the afternoon and in
the evening
● Avoid wearing constricting clothing such as
panty girdles or knee high stockings= can
impeded lower extremity circulation and
venous return.
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