Commom Minor Discomforts

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Commom Minor Discomforts

Heart Burn:

Aka à pyrosis.

Causes:

back up of stomach acids
gastric reflux
growing uterus displaces stomach
relaxin relaxes cardiac sphincter and gastric juices flow backwards
Interventions:
upright 30 min-1hour after meals
smaller more frequent meals
no spicy foods
antacids, Mylanta and Maalox (no soda)

Backache:

AKA à lordosis.

Causes:

center of gravity changes
relaxing of joint cartilages
Interventions:
no high heels
avoid straining when lifting
resting
firm mattress
pelvic rock
tailor sitting

With any pregnant woman, a backache should be investigated.

It could be a UTI.

Edema

Causes:

prolonged standing decreases venous return and also causes pressure on femoral vesssel
commonly occurs in feet
dangerous if in face and hands (non-dependent edema)
Dangerous to also see edema that is not relieved by elevation, with weight gain, increased BP and proteinuria.
Interventions:
elevate extremeties
normal salt diet (1-2 grams)
don’t stand or sit too long
put support hose on before getting out of bed

Travel:

Avoid travel in last trimester.

Best is 2^nd trimester.

Seat belt goes between breasts with lap belt under abdomen.

Stop frequently for rest and bathroom breaks.

Carry emergency numbers.

Don’t fly at 7^th month.

Nutrition:

Most important nutrient is protein.

Animal sources have the essential amino acids and plants have the incomplete sources.

Iron:

Need vitamin C for absorption.

Dairy decreases absorption.

In red meat, dark green leafy veggies, liver.

Function is RBC production.

For first 6 months, baby needs iron fortified formula.

Iron supplement causes constipation and nausea, so take on an empty stomach.

Calcium:

Oatmeal, dry beans, dark green leafy veggies, broccoli.

Folic acid:

0.4mg/day.

Dark green leafy veggies.

Prevents neural tube defects in the first weeks of pregnancy.

Calories:

300 calories over regular diet.

<1500 is inadequate.

Breast and Nipple Care:

Support bra.

Wash with plain water.

Toughen nipples with a dry towel.

Can put lanolin on them to keep supple.

Leg Cramps:

Imbalance of calcium and phosphorus.

Muscle spasm.

Standing.

Dorsiflexion of gastrocnemius.

Vaginal Discharge:

AKA à leukorrhea.

Due to hormonal changes.

Not normal:

Yeast infection à caused by candida albicans. Itches. Cottage cheese discharge. Mycostatin is an antifungal and can be given in 2^nd and 3^rd trimester by applicator if not dilated. If not treated, baby can have thrush when delivered.

Trichomonas à caused by a protozoan. Offensive odor. Itching. Treat with flagyl if NOT pregnant. ABC cream if pregnant.

Nausea and Vomiting:

Secondary to increased level of HCG.

Slowing of peristalsis.

See about 3^rd week, subside 12-14 week.

Eat crackers before rising.

Smaller more frequent meals.

Limit fluids at meal time.

Reduce fat intake.

High protein snack at bedtime.

NO OTC antiemetic.

Keep odors away.

Keep cold food cold and hot food hot.

Headache:

Give tylenol.

Always needs to be investigated.

Sexual Activity:

Contraindicated:

premature ROM
vaginal bleeding
premature labor (prostiglandin in semen stimulates mild contractions)
habitual abortions

By 3^rd trimester, may need to choose a new position.