PREGNANCY

DISCOMFORTS and
INTERVENTIONS

Ma. Khatrina Capati

Norlyn Marrie Viloria
The common discomforts
of pregnancy result
from physical and
anatomic changes and
are fairly specific to
each of the three
trimesters.
First Trimester
The dramatic hormonal
changes of the first
trimester account for many
of the discomforts
experienced in this period.
These discomforts tend to
subside by the beginning of
the fourth month of
pregnancy.
1. Nausea and
Vomiting
Influencing Factors:
• Increased levels of HCG
• Changes in CHO
metabolism
• Emotional factors
• Fatigue
Interventions:
• Avoid odors or causative factors.
• Eat dry crackers or toast before
arising in morning.
• Have small but frequent meals.
• Avoid greasy or highly seasoned
foods.
• Take dry meals with fluids between
meals.
• Drink carbonated beverages.
2. Urinary
Frequency
Influencing Factor:
• Pressure of uterus on
bladder in both first
and third trimesters
Interventions:
• Void when urge is felt.
• Increase fluid intake during
the day.
• Decrease fluid intake only in
the evening to decrease
nocturia.
3. Fatigue
Influencing Factors:
• Specific causative factors
unknown
• May be aggravated by
nocturia due to urinary
frequency
Interventions:
• Plan time for nap or rest
period daily.
• Go to bed earlier.
• Seek family support and
assistance with
responsibilities so that more
time is available to rest.
4. Breast
Tenderness
Influencing Factor:
• Increased levels of estrogen
and progesterone
Intervention:
• Wear well-fitting,
supportive bra (wide
shoulder strap)
5. Increased Vaginal
Discharge
Influencing Factor:
• Hyperplasia of vaginal
mucosa and increased
production of mucus by the
endocervical glands due to
the increase in estrogen
levels
Interventions:
• Promote cleanliness by daily
bathing.
• Avoid douching, nylon
underpants, and pantyhose;
cotton underpants are more
absorbent; powder can be
used to maintain dryness if
not allowed to cake.
6. Nasal Stuffiness
and Nosebleed
Influencing Factor:
• Elevated estrogen levels
Intervention:
• May be unresponsive, but
cool-air vaporizer may help;
avoid use of nasal sprays and
decongestants.
7. Ptyalism
Influencing Factor:
• Specific causative factors
unknown
Intervention:
• Use astringent mouthwashes,
chew gum, or suck hard
candy
 Second and
Third Trimesters
It is more difficult to classify
discomforts as specifically
occurring in the second or
third trimesters because may
problems represent
individual variations in
women.
8. Heartburn
Influencing Factor:
• Increased production of
progesterone, decreasing
gastrointestinal motility and
increasing relaxation of cardiac
sphincter, displacement of
stomach by enlarging uterus,
thus regurgitation of acidic
gastric contents into the
esophagus
Interventions:
• Eat small and more frequent
meals.
• Use low-sodium antacids.
• Avoid overeating, fatty and
fried foods, lying down after
eating, and sodium
bicarbonate.
9. Ankle Edema
Influencing Factors:
• Prolonged standing or sitting
• Increased levels of sodium due to
hormonal influences
• Circulatory congestion of lower
extremities
• Increased capillary permeability
• Varicose veins
Interventions:
• Practice frequent dorsiflexion
of feet when prolonged sitting
or standing is necessary.
• Elevate legs when sitting or
resting.
• Avoid tight garters or
restrictive bands around legs.
10. Varicose Veins
Influencing Factors:
• Venous congestion in the
lower veins that increases
with pregnancy
• Hereditary factors
(weakening of walls of veins,
faulty valves)
• Increased age and weight
Interventions:
• Elevate legs frequently.
• Wear supportive hose.
• Avoid crossing legs at the
knees, standing for long
periods, garters, and hosiery
with constrictive bands.
11. Hemmorhoids
Influencing Factors:
• Constipation
• Increased pressure from
gravid uterus on
hemorrhoidal veins
Interventions:
• Avoid constipation.
• Apply ice packs, topical
ointment, anesthetic agents,
warm soaks, or sitz baths;
gently reinsert into rectum as
necessary.
12. Constipation
Influencing Factors:
• Increased levels of progesterone,
which cause general bowel
sluggishness
• Pressure of enlarging uterus on
intestine
• Iron supplements
• Diet, lack of exercise, and
decreased fluids
Interventions:
• Increase fluid intake, fiber in
the diet, and exercise.
• Develop regular bowel habits.
• Use stool softeners as
recommended by physician.
13. Backache
Influencing Factors:
• Increased curvature of the
lumbosacral vertebrae as the uterus
enlarges
• Increased levels of hormones, which
cause softening of cartilage in body
joints
• Fatigue
• Poor body mechanics
Interventions:
• Use proper body mechanics.
• Practice the pelvic-tilt
exercise.
• Avoid uncomfortable working
heights, high-heeled shoes,
lifting heavy loads, and
fatigue.
14. Leg Cramps
Influencing Factors:
• Imbalance of
calcium/phosphorus ratio
• Increased pressure of uterus on
nerves
• Fatigue
• Poor circulation to lower
extremities
Interventions:
• Practice dorsiflexion to feet to
stretch affected muscle.
• Evaluate diet.
• Apply heat to affected
muscles.
• Arise slowly from resting
position.
15. Faintness
Influencing Factors:
• Postural hypotension
• Sudden change of position
causing venous pooling in
dependent veins
• Standing for long periods in
warm area
• Anemia
Interventions:
• Avoid prolonged standing in
warm or stuffy environments.
• Evaluate hematocrit and
hemoglobin.
16. Dyspnea
Influencing Factor:
• Decreased vital capacity from
pressure of enlarging uterus on the
diaphragm
Interventions:
• Use proper posture when sitting
and standing.
• Sleep propped up with pillows for
relief if problem occurs at night.
17. Flatulence
Influencing Factors:
• Decreased gastrointestinal
motility leading to delayed
emptying time
• Pressure of growing uterus on
large intestine
• Air swallowing
Interventions:
• Avoid gas-forming foods.
• Chew food thoroughly.
• Get regular daily exercise.
• Maintain normal bowel habits.
18. Carpal Tunnel
Syndrome
Influencing Factors:
• Compression of median nerve
in carpal tunnel of wrist
• Aggravated by repetitive
hand movements
Interventions:
• Avoid aggravating hand
movements.
• Use splint as prescribed.
• Elevate affected arm.
19. Round Ligament
Syndrome
Influencing Factors:
• Enlargement of the uterus
causing round ligaments stretch
and hypertrophy as the uterus
rises up in the abdomen.
Intervention:
• Applying heat pad brings relief.