Question

Assignment # 4 – Maternal Adaptation

1. Develop a nursing care planusing the patient scenario below (Nursing care plan template located in assignments).

Alli is pregnant and at 37 weeks’ gestation. She has come to the office for her routine prenatal visit and is discussing issues of concern with the nurse. Alli states she is having a difficult time sleeping because she is always getting up to use the restroom. If she is not using the restroom, she has problems with heartburn.

Include in the teaching plan The changes which occur during pregnancy related to urinary frequency.

The changes which occur during pregnancy related to heartburn and how to manage this problem.

Answer 1

Nursing care for a pregnant women include

●Assessment:

▪assess the parametres of normal preganancy ▪ assess any risk factor, complication which devitate from the normal pregnancy

▪ check the vitals of the patient / physical examination.( blood pressure, weight, pulse rate, respiratiry rate, measurement if uterus)

▪ assess for any viginal bleeding

● interview: ask her for any other complaints or discomforts.

● nutsing diagnosis: like constipation, anxiety, imbalanced nutrition, disturbed sleeping pattern,

●Emotional support: encourage and emotionaly supports her.

●Health education :

▪educate her about the variations or physiological changes that can happened during last trimester .

▪Explain and teach her about the discomforts. ▪Advice her to eat more fruits and vegetables and nutritious food.

▪Advice her to take proper rest and avoid stress

Pregnancy increases the urge to urinate. This can make a pregnant women wake up frok her sleep. Due to increasing level of hormones in pregnancy , bodys fluid level also get increased. In this case kidney have to remove the extra fluid in your body which increase frequency of urination. In last stages of pregnency ( 3 trimester) the size of the utetus is growing as the baby develops which increases the pressure on  the bladder causing frequent urination.

Pregnancy hormones like progesterone relaxes the valves between stomach and esophagus , which allow the reflux of acid from stomach to esophagus causing heart burn.

Heart burn are common during last trimester. Developing fetus increases pressure on stomach and intestine leading to efulx of acid from stomach to esophagus.

Due to elevated  progesteron level digestion of food slows down, stomach remain full for a long time and this increases the chance  of heart burn.

To prevent or reduce the heart burn following tios can be used.

▪ eat small and frequent meals (5_6 times) instead of eating large meals.

▪ avoid fried, spicy and oily foods

▪ avoids fruits which contain citrus acid like lemon, orange etc

▪ avoid caffeine, chocolates, sodas and other acidic foods.

▪ wait at least one  hour after meal before laying down.

▪ elevate head using a pillow while sleeping

▪ can drink a glass of milk or yogurt to reduce heart burn.