Question

Case Scenario:

Ruba is a 39 years old, pregnant woman at 8 weeks gestation, and her husband, Ali, is 50 years old, arrives at antenatal clinic for follow-up. The couples have been married for 12 years. Ruba completes the initial paperwork, and the nurse notes the following obstetric history: G6 T0 P0 A5 L0 M0. Ruba and Ali asked the nurse many questions regarding Down syndrome as Ali’s sister, recently, has a boy with Down syndrome.

Q1: As Ruba has many questions regarding her pregnancy, including the physiological and psychological changes, labor process and postpartum period. The nurse advice Ruba and Ali to attend antenatal classes. List six topics should be covered in the childbirth preparation program that may help to answer Ruba’s inquiries.

Q2: After 7 months, Ruba is approximately 37 weeks gestation. She comes for antenatal follow-up visit complaining of backache, leg cramps, heartburn, constipation, and difficulty sleeping at night. Describe three nursing management for each Ruba’s complain (minor discomfort).   

A. Backache :

B. Leg cramps :

C. Heartburn:

D. Constipation:

E. Difficulty sleeping at night      

Answer 1

Answers

Q1.

Child birth is one of the greatest events in every woman’s life. Child birth classes help to build up confidence in womans body’s ability to give birth. They can discuss their fears about labour and birth with the instructors and other couples with the same concern. The partner will learn about child birth and support them.

The goals of childbirth classes consists of providing supportive therapy, reducing anxiety, providing factual information and maintaining a focus on current concerns.

Topics for childbirth classes

1. Prenatal visits, monior ailments and warning signs of pregnancy.

2. Physiologic and psychological changes during pregnancy

3. Genetic disorders, chromosomal abnormalities and Informations about medical procedures : It consists of especially regarding the prenatal tests such as amniocentesis, cordocentesis, chorionic villus sampling, triple test, quadriple test, nuchal translucency scan etc.

4. Healthy life style: It includes diet, exercises, sleep and rest, personal hygeine, drugs, radiation exposure and immunization. Importance follic acid, Iron and calcium supplementation.

5. Normal labour, Positioning for labour and birth,Rlaxation and massaging technique to alleviate pain

6. Physiological changes during early post partum period and Breast feeding

Q2.

The minor disorders during pregnancy may occur due to hormonal changes, accomodation changes, metabolic changes and postural changes.

A. Backache :

1) Advice regarding the comfortable positions in sitting, standing, lying, general mobility and how to lift correctly.

2) Postural re-education, including correction of the pelvic tilt.

3) Regular antenatal exercises, which strengthens muscles and boosts flexibility.

B. Leg cramps :

1) Make gentle leg movements in a warm bath before going to the bed in the night.

2) Sleep with the foot end of the bed elevated by 20-25 cm.

3) Take vitamin B complex and calcium supplements

C. Heartburn:

1) Small meals take less room in the reduced stomach space and are digested more easily, avoid fried and fatty foods.

2) Avoid bending and kneeling while doing household activities.

3) Sleep with more pillows than usual and lie on the right side semi reclining position. Administer antacids for persistent heartburn.

D. Constipation:

1) Increase the intake of water. Take a glass of warm water in the morning before tea or breakfast which helps for regular bowel movements.

2) Add green leafy vegetables, fruits and cereals to the antenatal diet

3) Regular antenatal exercises and walking

E. Difficulty sleeping at night

1) Drink a glass of warm milk at bed time.

2) Lie in left lateral position and tuck a pillow under the abdomen when lying in a lateral position.

3) Take rest in the afternoon. Talk about fear and anxieties of the patient. So that she can have a sense of normality and lightness.