Question

Signs and Symptoms of Pregnancy

Provide the implications of the given disorder as well as the nursing actions or interventions

I Presumptive	Cause/ Physiologic basis	Nursing Action/s in the Care of clients
1) amenorrhea
2) nausea & vomiting
3) urinary frequency
4) breast changes & tenderness
5) excessive fatigue
6) uterine enlargement
7) quickening
II Probable changes	Cause/ Physiologic basis	Nursing Implication/s
1) changes in pelvic organs -Goodell sign -Hegar sign -Piskacek sign
2) (+) HCG
3)Uterine souffle
4) Skin pigmentation
5) Ultrasound
III Positive (diagnostic) changes	When appreciated & how appreciated	Nursing Implication/s
1) Fetal heart beat
2) Fetal movements
3) Ultrasound (presence of fetus)

Answer 1

Presumptive	Cause/ Physiologic basis	Nursing Action/s in the Care of clients
1) amenorrhea	1 st sign of pregnancy absense of menstruation	-educate the women about amenorrhoea is normal during pregnancy -tell her to take medical advice if she has bleeding and spotting
2) nausea & vomiting	-hormonal changes,Hormones slow down digestion, which could trigger heartburn, indigestion, and acid reflux, which are all considered possible symptoms of pregnancy and potential triggers of vomiting during pregnancy. -sensitive to smell -imbalnced nutrition -acid base imbalnce	-advise the women to eat snacks frequently and have multiple small meals - never leave stomach empty - prenatal vitamin intake -avoid food which smell cause nuasea -take plentyof water check for dehydration
3) urinary frequency	- It's caused by an increase of the hormones progesterone and human chorionic gonadotropin - also when the size ofthe uterus increses this will out pressure on bladder,so the pregnant women urinate frequently body’s fluid levels start to increase during pregnancy. This means your kidneys have to work extra hard to flush the extra fluid	- health educate the women that it is normal during pregnacy so do not cutback drinking water -avoid caffeinated beverages - teach pelvic muscle strengthening excercise(kegel excecise)
4) breast changes & tenderness	- estogen and progestron is responsible for this - fat build up in breast -incresed blood flow to the area -brest is going to become a milk making machine after few months so they need to get ready for that	- teach them about this is normal during pregnacy -advicethrm to wear a support perfect size bra to avoid sagging -apply lotions skin streching may cause itching -wear brest pads for leakge - take medical attension if she has any lumps or unusual dicharge from breast
5) excessive fatigue	- incresed levels of estrogen and progestron act as a natural sedative - body is working hard for growing up your unborn baby( production of blood and nutrients)	-tell the patient to take rest adequately -eat a balanced diet -refresh themself with music and fresh juices -regular moderate excercises
6) uterine enlargement	- this is due to the growth of the fetus inside the womb, the uterus become enlarge as then baby develops	-teach the pregnant women that her belly size will increse as the baby grows inside -
7) quickening	-fluttery sensation experienced by a mom-to-be when she first feels her baby move.	-teach her about that is the fetal movements and to take medical attension if she is not getting any fetal movement every 3 hrs -tell her to count the fetal movement -Providing clients with “fetal kick count” charts to record movement helps promote compliance
II Probable changes	Cause/ Physiologic basis	Nursing Implication/s
1) changes in pelvic organs -Goodell sign -Hegar sign -Piskacek sign	Softening of the cervix :Goodell's sign Softening of the uterus : Hegar's sign noting a palpable lateral bulge or soft prominence one of the locations where the uterine tube meets the uterus. :Piskacek sign	- assist in pelvic examination and clarify the doubts of the clients, provode emotional and comfotable support to women - assess the strenghth of te vaginal wall -take the three mesurements : diagonal conjugate, true conjugate, and ischial tuberosity -assess if she can deliver normally
2) (+) HCG	level of hcg in urine positive pregnancy test - more than 25 U/L	check the levels of hcg and health educate the normal range and the client how to take care of health for her baby
3)Uterine souffle	is a soft, blowing sound heard using a stethoscope, usually in the second trimester of pregnancy (13–28 weeks). This sound is heard most clearly in the lower part of the uterus and is synchronous with the pulse of the mother.	- health educate the pregnant women to watch for fetal heart rate and to seek medical attention if any abnormality founds
4) Skin pigmentation	melasma : darker skin , blotchy spots linea nigra dark line that you may notice running down belly.	educate the client that do not get worry about it skin pigmentations will go automatically after delivery - use sunprotection -no waxing - apply conceler use hypo allrgenic products
5) Ultrasound	Transabdominal ultrasound. Transvaginal ultrasound. Doppler ultrasound. 3-D ultrasound. 4-D ultrasound.	- educate the patient regarding how to prepare for usg scan and why each ultrasound is doing about gentical abnormality
III Positive (diagnostic) changes	When appreciated & how appreciated	Nursing Implication/s
1) Fetal heart beat	around 6 weeks   110 and 160 beats per minute - external fetal heart monitoring -internal fetal heart monitoring	-abnormal fetal heart rate may mean that your baby is not getting enough oxygen or that there are other problems. - check the fetal heart rate and assist the monitoring procedure
2) Fetal movements	- 16 weeks: quikening( flutter , kick, swiss , roll) - 10 or more fetal movements in two hours	- teach them to take a medical attension if the baby is not moving or decrese movements
3) Ultrasound (presence of fetus)	- 6 th week - tvs scan -14 th week- NT scan -20 th week-anomaly scan -24 th week - growth scan -doppler scan on 30 th week all ultrasounds are used to determine the growth the unborn baby. and to check the genetic deformities