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. 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

Since the problems mentioned are minor and the patient is in the last stage of pregnancy,it would be better to opt non-pharmacological approaches for symptoms relief.

A)Backache

1)Practise low impact exercises:Though pregnancy requires rest,lying for long periods can aggravate backpain.So practice low impact exercises like yoga that helps in building muscles to support the back and can improve the posture and balance .

2)Try lying on the sides:Lying on back for long periods can put pressure on the pelvis and bacthe causelowee back ,which can be managed by turning to one side and keeping a pillow to support the abdomen or between the knees

3)Cold or hot compresses:It is better not to take any medications for managing pain,instead hot or cold compresses can help to ease the pain.

B)Leg cramps

1)Stretch the calf muscles:This can be done by stretching with the heels flexed,especially before going to bed in case of cramps at night.Do gentle massage on the calf to relax the muscle.

2)Be active:Avoid sitting or standing in one position for a long time.Also,avoid sitting with the legs crossed as it may affect the proper blood flow.

3)Stay hydrated:Muscles need proper hydration for the prevention of cramps.

C)Heartburn

1)Practice good eating habits : Have small frequent meals each day instead of large ones,also eat slowly

2)Choose proper food:Avoid foods that can trigger heart burn such as spicy and fat rich foods or any foods that can cause relaxation of the lower esophageal sphincter.

3)Slight head elevation while lying down:This helps in preventing stomach acids from rising into the esophagus.

D)Constipationi

1) Increase fiber intake: Eating more fibrous foods, such as fruits, vegetables, and whole grains can facilitate stool passage.

2)Have plenty of fluids: This can keep stool soft and easy to pass.

3)Include probiotics in diet: Food rich in probiotic such as yogurt may help repopulate the gut bacteria with healthy strains that encourage normal and regular bowel movements.

E)Difficulty sleeping at night

1)Practice sleep hygiene:This includes keeping a proper schedule for sleeping and waking up,maintaining an atmosphere suitable for sleep(eg.dark bedroom),limiting intake of caffeine or other stimulants before going to bed and so on.

2)Use of relaxtion techniques:This includes simple breathing exercises and meditation that can help to minimize anxiety and favours good sleep

3)Avoid screens at night:This includes television and mobile phones that can distract the sleep.