DAUZ, LAUREL JOSHUA R.
BSN 2-A
Activity in NCM 107 OB Lecture
1. Identify the common psychological and physiological changes that occur with pregnancy
and integrate your knowledge regarding these changes to achieve quality maternal and
child nursing care. (20 points)
PHYSIOLOGICAL/PSYCH CAUSES
OLOGICAL CHANGES
Plasma volume increases Increase of red blood cell
and blood flow to organs
which requires oxygen.
Platelet counts decreases Due in part to
hemodilution: the body
makes more plasma during
pregnancy, so the total
number of platelets per
volume of blood will be
lowered
Venous stasis Compression of the left
iliac artery and the ovarian
artery
Vaginal pH decreases Hormonal fluctuation
INTERVENTION
 Plasma volume expansion
is an important
component of a
successful pregnancy.
 The failure of maternal
plasma volume expansion
has been implicated in
adverse obstetric
outcomes such as pre-
eclampsia, fetal growth
restriction, and preterm
birth
 Take folate and vitamin
B12 supplements to
support platelet
production
 Certain foods can also
help increase your platelet
level including: eggs, dark
chocolate leafy green
vegetables and fatty fish
such as salmon.
 Wear compression
stockings. They ease
swelling and improve
blood flow.
 Keep your feet elevated
above your heart. When
you can, do it for 15
minutes every 2 hours
and while you sleep.
 Don't stand still for too
long. Walk around often.
 Avoid harsh soaps and
douching
 Take probiotic
supplement or
suppository
 Eat yogurt
Heart rate increases Reaction to the increase in  Take your blood pressure
blood volume medication as prescribed.
Your health care provider
will prescribe the safest
medication at the most
appropriate dose.
 Stay active. Follow your
health care provider's
recommendations for
physical activity.
 Eat a healthy diet. Ask to
speak with a nutritionist if
you need additional help.
 Know what's off-limits.
Avoid smoking, alcohol
and illicit drugs. Talk to
your health care provider
before taking over-the-
counter medications

2. Assess the different diagnosis of pregnancy ( 20 points)

PRESUMPTIVE SIGNS PROBABLE SIGNS POSITIVE SIGNS

 Amenorrhea (no  Increased frequency  Fetal heartbeat
period) of urination  Visualization of fetus
 Nausea — with or  Soft cervix (ultrasound)
without vomiting  Abdominal  Positive hCG urine or
 Breast enlargement bloating/enlargement blood
and tenderness  Mild uterine
 Fatigue cramping/discomfort
 Poor sleep without bleeding
 Back pain  Increased skin
 Constipation pigmentation in the
 Food cravings and face, stomach, and/or
aversions areola
 Mood changes or
"mood swings"
 Heartburn
 Nasal congestion
 Shortness of breath
 Lightheadedness
 Elevated basal body
temperature (BBT)
 Spider veins
 Reddening of the
palms
 3. Discuss the common preparations for childbirth and Parenting including common
settings for birth. ( 20 points)
Preparation for childbirth
 Grantly dick-read method – according to it prenatal courses and training reduces fear,
overcome ignorance, and built a woman’s self-confidence, it includes; explanations
related to childbirth process and procedure, methods available to relieve pain, exercises
and breathing techniques.
 Psycho-prophylactic or Lamaze method – in this method the woman is taught to replace
responses of restlessness, fear and the loss of control with more useful activity.
 The bradly method – commonly referred to as husband-coached childbirth, although the
coach is not necessarily the husband of women. Coaches are supporters of the women
from her family who attend childbirth classes with women and learn to help the women
long before the labor begins. The coach serves as a conditioned stimulus using the
sound of his or her voice. Use of particular words and repetition of practice.
Preparedness for birth process include the following activities;

 Decision making in an emergency

 Skilled birth attendant
 Supplies needed for clean delivery
Preparation for parenthood
 Physical preparedness – thorough physical check-up is necessary to ensure that the
reproductive organs and their functions are healthy. To diagnose any deviation or
abnormalities which may lead to infertility or congenital defects or abortion.
 Psychological preparedness - a couple should develop a favorable attitude about child
bearing and child rearing to react positively and to adjust well. Certain favorable
attitudes, feelings and experiences which have to include by the couple are; wanting a
child, wanting a normal healthy child, satisfied with gender.
 Financial preparation – having a baby is an added expense in the family. Couple has to
save money regularly from income in preparation for the baby. Financial security by
medical insurance can be enrolled by couple.

4. Elaborate the different Discomforts of Pregnancy, causes and management. You may
present it using table  ( 20 points)

DISCOMFORTS OF CAUSES MANAGEMENT

PREGNANCY
Breast swelling and Expanding milk ducts and  Wear a bra that provides firm
pain breast fill comforts such as cotton bras
or those made from natural
fibers.
 Get a bigger bra as your
breast become larger and
fuller.
 Your bra should fit well
without irritating your

Fatigue Growing baby’s energy
requirements. In some cases,
fatigue is due to anemia
Hemorrhoids Pressure on the rectum from
the growing baby combines
with an increased blood
volume
constipation Growing baby putting pressure
on the intestines and
increased iron intake from
prenatal vitamins
nipples. Try maternity or
nursing bras, which provide
more support and can be
used after pregnancy if you
choose to breastfeed
 Get plenty of rest, go to bed
earlier and take naps.
 Keep a regular schedule
when possible.
 Pace yourself and balance
activity with rest.
 Moderate exercise daily
boosts your energy level.
 Ask your health care
provider to test your blood
routinely for anemia
  Try to avoid constipation.
Constipation can cause
hemorrhoids and will make
them more painful.
  Avoid sitting or standing for
long periods of time; change
your position frequently.
  Don't strain during a bowel
movement.
  Apply ice packs or cold
compresses to the area or
take a warm bath a few
times a day to provide relief.
  Avoid tight-fitting
underwear, pants, or
pantyhose.
  If you still need more help,
consult your health care
provider
 Add more fiber (such as
whole grain foods, fresh
fruits, and vegetables) to
your diet.
  Drink plenty of fluids daily
(at least 6-8 glasses of water
and 1-2 glasses of fruit or
prune juice).
  Drink warm liquids,
especially in the morning.
  Exercise daily. Walking
and swimming are activities
that are gentle on your
pregnant body.

Varicose veins Increased pressure on the legs
and the pelvic veins and
increased blood volume
Frequent urination Pressure from the growing
baby on the bladder
Swelling/bloating/flui Pressure from the growing
d retention uterus on the blood vessels
carrying blood from the lower
body
  Avoid straining when you
have a bowel movement.
 Talk with your doctor about
a laxative or stool softener.
 Avoid standing or sitting in
one place for long periods.
It's important to get up and
move around often.
 Avoid remaining in any
position that might restrict
the circulation in your legs
(such as crossing your legs
while sitting).
 Elevate your legs and feet
while sitting.
 Exercise regularly.
 Wear support hose. Avoid
socks or knee-highs that are
too tight or constraining.
  Sleep or rest on your left
side to ease pressure on the
vein that carries blood from
your feet to your heart. It's
on your right side.
 Don’t wear tight-fitting
underwear, pants or
pantyhose.
 Drink plenty of fluids to avoid
dehydration.
 Try to get the mostly during
the day and drink less in the
evening. This should help
you cut back on nighttime
bathroom visits.
 Avoid coffee, tea, colas and
other caffeinated drink.
These can make you more
urinate
 Do gentle exercise, such as
walking or swimming which
helps keep the digestive
system moving.
 Drink water throughout the
day to help digestion.
 Eat smaller meals more
often and eat foods high in
fiber, such as fruits,
vegetables and whole grains
Abdominal pain Stretching ligaments that run  Change your position or
from the uterus to the groin activity until you are
comfortable; avoid sharp
turns or movements.
  If you have a sudden pain in
your abdomen, bend forward
to the point of pain to relieve
tension and relax the tissue.
  Apply a hot water bottle or
heating pad to your back, or
take a warm bath or shower.
  Try a massage.
  Make sure you are getting
enough fluids.
 Take Tylenol
(acetaminophen)
occasionally.
 Contact your health care
provider if the pain is severe
or constant or if you are less
than 36 weeks pregnant and
you have signs of labor.
(Signs of labor include
repetitive cramping like
contractions.)
Stretch marks Rapid weight gain  Be sure that your diet
contains enough sources of
the nutrients needed
for healthy skin (especially
vitamins C and E).
 Apply lotion to your skin to
keep it soft and reduce
dryness.
 Exercise daily

5. Identify the different danger signals of pregnancy and its complication and management
( 20 points)

DANGER SIGNS OF COMPLICATIONS MANAGEMENT

PREGNANCY
Profuse vaginal bleeding  Miscarriage
 Placental abruption
 Placenta previa
 Ectopic pregnancy
 Getting plenty of rest.
 Using pads rather
than tampons while
you are bleeding.
 Avoiding sex while
you are bleeding. Sex
can resume once the
bleeding has stopped.
 Taking mild pain relief
 medication, such as
paracetamol, if
needed.
 Reporting any
changes in your
condition to your
doctor.
Pelvic or abdominal pain  Placental abruption  Rest until you feel
 Preeclampsia better.
 HELLP syndrome  Take a warm bath.
 Think about what you
drink and eat:
 Drink plenty of fluids.
Choose water and
other caffeine-free
clear liquids until you
feel better.
 Try eating small,
frequent meals. If
your stomach is
upset, try bland, low-
fat foods like plain
rice, broiled chicken,
toast, and yogurt.
 Think about how you
move if you are
having brief pains
from stretching of the
round ligaments.
 Try gentle stretching.
 Move a little more
slowly when turning in
bed or getting up from
a chair, so those
ligaments don't
stretch quickly.
 Lean forward a bit if
you think you are
going to cough or
sneeze
Persistent back pain  Miscarriage  Practice good posture
 Preterm labor to avoid falling
forward, you might
compensate by
leaning back.
 Stand up straight and
tall
 Hold chest high
 Keep your shoulders
back and relaxed

Gush of fluid from vagina
Swelling of the hands or face
Severe headaches, blurred
vision
 Don’t lock your knees
 Sleep on your side,
not your back. Keep
one or both knees
bent
 Try to apply of heating
pad or ice pack to
your back
 Preterm labor  Inform your doctor
 Preterm rupture of immediately.
membranes  You keep a track of
 Miscarriage when the leakage
 Placental abruption began and the
amount of leakage.
 You don’t insert
fingers or anything
else into the vagina.
 Your gynecologist will
check whether the
leakage is indeed
amniotic fluid and
then suggest an
appropriate method of
treatment. In case the
baby is fully
developed, you may
also be recommended
to have labor induced
and deliver.
 Preeclampsia  Avoid standing for
long periods
 Wear comfortable
shoes and socks –
avoid tight straps or
anything that might
pinch if your feet swell
 Try to rest with your
feet up as much as
you can
 Drink plenty of water
– this helps your body
get rid of excess
water
 Exercise – try to take
regular walks during
the day or doing foot
exercises
 Preeclampsia  Applying a cold or
 Eclampsia warm compress to the
area for 10 minutes at

Regular contractions before
37 weeks
a time
 Taking a warm bath to
release muscle
tension
 Stretching
 Doing mild exercises,
such as yoga,
swimming, or tai chi
 Sitting or standing
with better posture
 Taking frequent
breaks away from
screens
 Drinking plenty of
water throughout the
day
 Getting plenty of rest
 Getting a gentle head
massage
 Resting in a dark area
 Preterm labor  Eat a well-balanced
diet, including extra
calcium, iron, and folic
acid.
 Take a prenatal
vitamin every day –
starting a few months
before you get
pregnant if possible.
 Stay away from
tobacco, alcohol and
illegal drugs
throughout your
pregnancy.
 Check with your
doctor regarding any
medication you take,
including over the
counter medicine and
herbal supplements.
 Consider discussing
pregnancy spacing
with your doctor.
 Your doctor might
recommend
medication to reduce
the risk of early labor,
including weekly
injections or vaginal
suppositories of
 progesterone during
your second trimester.

No fetal movements  Fetal distress  Expectant

 Infection management with
 Low amniotic fluid close surveillance of
volume the baby
 Cardiotocography
(visual or analyzed by
computer to follow the
baby’s heart beat with
uterine activity)
 Ultrasound
examination including
doppler ultrasound
and fetal arousal test
to assess the baby’s
well being