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The Expectant Family

The Expectant Family . Chapter 11. Common Discomforts of Pregnancy. Constipation Nausea/Vomiting Rest Urinary frequency Breast tenderness Fatigue Increased vaginal discharge. Anticipatory Guidance. Involve father in PNC What to expect Encourage to attend classes

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The Expectant Family

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  1. The Expectant Family Chapter 11

  2. Common Discomforts of Pregnancy • Constipation • Nausea/Vomiting • Rest • Urinary frequency • Breast tenderness • Fatigue • Increased vaginal discharge

  3. Anticipatory Guidance • Involve father in PNC • What to expect • Encourage to attend classes • Assess family unit i.e. siblings

  4. Relief of Common Discomforts • Morning sickness-cause by increase in hCG • Small frequent meals, avoid lying, take OTC meds • Assess for S/S of dehydration • Urinary frequency • Report burning, urgency, pain, and blood • Intake= 2000 cc /day. Do not decrease fluid intake

  5. Relief of Common Discomforts • Fatigue- presumptive, difficult to rest and sleep • Breast tenderness- increase in estrogen and progesterone • Leukorrhea- hyperplasia of vaginal discharge. • Epitaxis and nasal stuffiness- increase estrogen. • NI- use vaporizer, no meds • Ptyalism- bitter saliva

  6. Second and Third Trimester • Pyrosis- heartburn • Causes – progesterone, decrease in gastric motility, relaxation of cardiac sphincter • Use low sodium antacids • Ankle edema-slow venous return • Avoid prolonged sitting, standing, hot weather • Assess for proteinuiria and hypertension

  7. Second and Third Trimester • Varicosities-weak vein wall or incompetent valves. • Wear support stocking, avoid standing and sitting • Hemorrhoids-varicosities of rectal vein • DO NOT STRAIN • Constipation- caused by progesterone, iron, fetal growth, displacement of intestines. • Give stool softeners

  8. Second and Third Trimester • Dyspnea-pressure on diaphragm • Primigravida experience lightening (few weeks) • Round ligament pain • Carpal tunnel- pressure on median nerve • Provide anticipatory guidance

  9. Self Care • Monitor fetal movement • Breast care- supportive bra and nipple preparation • Clothing- not too tight • Bathing- avoid hot water, slippery surfaces • Working • Avoid travel if high risk • Balance rest and exercise

  10. Exercises • Pelvic tilt- press back to floor • Abdominal exercise • Kegel- lift perineal muscles • Prevents urinary (cystocele) and fecal (rectocele) incontinence

  11. Sexual Activity • Avoid if high risk • Openly discuss feelings • Explore other forms of intimacy

  12. Teratogens • Avoid medications in first trimester • Cat. A- no fetal risk • Cat B- human studies support use- low risk • Cat C- no adequate studies or risk to animals • Cat D- harmful but benefits must outweigh risks • Cat. X

  13. Teratogens • Tobacco- associated LBW, PTL • Alcohol- FAS • Caffeine- use in moderation • Marijuana- r/t poly substance abuse • Cocaine- abruption, SGA, fetal distress, withdrawal

  14. “Older” Couples • Over 35 • Better educated and financially stable • Risks r/t preexisting conditions • PIH, GDM, genetic abnormalities • May be more assertive with provider • Screening-MFSAP, estriol, hCG, amniocentesis

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