The document discusses several common minor discomforts experienced during pregnancy, including their causes and nursing interventions. Nausea and vomiting in early pregnancy is caused by increased hormones and usually subsides by 12 weeks. Backaches are caused by relaxed joints and muscles from hormones. Edema in the legs is due to pressure from the uterus restricting blood flow. Nursing advice includes eating small, frequent meals; staying hydrated; getting adequate rest; and wearing support stockings.
Postnatal care (PNC) for the mother should respond to her special needs, starting within an hour after the delivery of the placenta and extending through the following six weeks. The care includes the prevention, early detection and treatment of complications, and the provision of counselling on breastfeeding, birth spacing, immunization and maternal nutrition. To standardise the PNC service, you are advised to use the screening, counselling and postnatal care cards. These cards ensure that you have covered all the essential steps in every home visit.
this ppt is beneficial for nursing and obstetric and gynaecology students.
BREAST CARE(PRECEDURE)
PRESENTED BY – M. MANJOT KAUR GILL
DEFINITION
Breast care is the process of cleaning the breast of mother that helps in maintaining hygiene and prevent from cross infection during feeding .
PURPOSES
To clean the breast.
To detect any abnormalities.
To stimulate milk ejection .
To prevent local infection.
To prevent breast complications.
INDICATIONS
Postnatal mothers.
Before and after breastfeeding.
Cracked nipple.
Pt. who are not able to take self care.
Nipple with unhygienic conditions.
PREPRATION OF ARTICLES
Screen
Mackintosh with towel.
A bowel with 2-3 cottons.
A bowel with boiled and cool cotton swabs.(12-15)
A bowel with dry gauze pieces.(12-15)
Kidney tray/Paper bag
Nursing records.
STEPS OF PROCEDURES.
Arrange all articles .
Explain the procedure to the mother about benefit of breast care.
Provide screen for privacy.
Provide comfortable position to the mother preferable sitting position.
Spread the mackintosh with towel over the lap of the mother.
Wash hand
Stand on the right side of the mother whole giving care.
Expose both the Brest firth and check symmetry.
Inspect the Breast for size and any abnormality.
-Inverted nipple
-Cracked nipple.
-Retracted nipples
-Any sign of infection
Palpate the breast from superficial to deep for tenderness, pain, tumors, exaggerated lymph nodes, etc
Squeeze the breast and observe the secretions.
Clean the secretion with the pad and throw In paper bag.
Take the cotton swab and squeeze excess water holding the tail and keeping above the hand.
Clean the breast in the following order—nipple-primary areola-secondary areola- total breast –lower crease-axilla.
Dry the breast with gauze pieces following the same order.
Cover the further breast exposing the near one.
Inspect, palpate and squeeze in the previous manner.
Assist the mother to do hand wash for return demonstration.
Assist the mother to clean the breast in same manner.
Put the baby on to the breast.
Make the mother and baby comfortable after care.
Record any abnormal findings.
SUMMARIZATION
Definition
Purposes
Indications
Articles
Steps of procedure
BIBLIOGRAPHY
Ghai, sandhya .(2018) clinical nursing procedures. New Delhi: satish kumar. Pp.613-616.
Dharitri, swain.(2017) obstetrics nursing procedure manual. New Delhi: jappee brothers. Pp. 158--159.
THANKS
Postnatal care (PNC) for the mother should respond to her special needs, starting within an hour after the delivery of the placenta and extending through the following six weeks. The care includes the prevention, early detection and treatment of complications, and the provision of counselling on breastfeeding, birth spacing, immunization and maternal nutrition. To standardise the PNC service, you are advised to use the screening, counselling and postnatal care cards. These cards ensure that you have covered all the essential steps in every home visit.
this ppt is beneficial for nursing and obstetric and gynaecology students.
BREAST CARE(PRECEDURE)
PRESENTED BY – M. MANJOT KAUR GILL
DEFINITION
Breast care is the process of cleaning the breast of mother that helps in maintaining hygiene and prevent from cross infection during feeding .
PURPOSES
To clean the breast.
To detect any abnormalities.
To stimulate milk ejection .
To prevent local infection.
To prevent breast complications.
INDICATIONS
Postnatal mothers.
Before and after breastfeeding.
Cracked nipple.
Pt. who are not able to take self care.
Nipple with unhygienic conditions.
PREPRATION OF ARTICLES
Screen
Mackintosh with towel.
A bowel with 2-3 cottons.
A bowel with boiled and cool cotton swabs.(12-15)
A bowel with dry gauze pieces.(12-15)
Kidney tray/Paper bag
Nursing records.
STEPS OF PROCEDURES.
Arrange all articles .
Explain the procedure to the mother about benefit of breast care.
Provide screen for privacy.
Provide comfortable position to the mother preferable sitting position.
Spread the mackintosh with towel over the lap of the mother.
Wash hand
Stand on the right side of the mother whole giving care.
Expose both the Brest firth and check symmetry.
Inspect the Breast for size and any abnormality.
-Inverted nipple
-Cracked nipple.
-Retracted nipples
-Any sign of infection
Palpate the breast from superficial to deep for tenderness, pain, tumors, exaggerated lymph nodes, etc
Squeeze the breast and observe the secretions.
Clean the secretion with the pad and throw In paper bag.
Take the cotton swab and squeeze excess water holding the tail and keeping above the hand.
Clean the breast in the following order—nipple-primary areola-secondary areola- total breast –lower crease-axilla.
Dry the breast with gauze pieces following the same order.
Cover the further breast exposing the near one.
Inspect, palpate and squeeze in the previous manner.
Assist the mother to do hand wash for return demonstration.
Assist the mother to clean the breast in same manner.
Put the baby on to the breast.
Make the mother and baby comfortable after care.
Record any abnormal findings.
SUMMARIZATION
Definition
Purposes
Indications
Articles
Steps of procedure
BIBLIOGRAPHY
Ghai, sandhya .(2018) clinical nursing procedures. New Delhi: satish kumar. Pp.613-616.
Dharitri, swain.(2017) obstetrics nursing procedure manual. New Delhi: jappee brothers. Pp. 158--159.
THANKS
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
The presentation contain:
Normal puerperium ; Physiology, Duration
Postnatal assessment and management
Promoting physical and emotional well-being
Lactation management
Immunization
Family dynamics after child-birth.
Family welfare services; methods, counseling
Follow-up
Records and reports
Health education on Antenatal care include definition,aim, objectives, registration, antenatal check up, immunization, iron & folic acid, diet, bowel care, cleanliness, clothing, shoes, dental care, care of breast, sleep, exercise, coitus, travel, smoking & alcohol, family support & dangers signs during pregnancy.
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
The presentation contain:
Normal puerperium ; Physiology, Duration
Postnatal assessment and management
Promoting physical and emotional well-being
Lactation management
Immunization
Family dynamics after child-birth.
Family welfare services; methods, counseling
Follow-up
Records and reports
Health education on Antenatal care include definition,aim, objectives, registration, antenatal check up, immunization, iron & folic acid, diet, bowel care, cleanliness, clothing, shoes, dental care, care of breast, sleep, exercise, coitus, travel, smoking & alcohol, family support & dangers signs during pregnancy.
OBSTETRICS & GYNAECOLOGICAL NURSING-
MINOR AILMENT DURING PREGNANCY-
INTRODUCTION-Many women experience some minor
disorder during pregnancy.
These disorder should be treated adequately as they may escalate and become life-threatening.
DEFINITION-“The minor complaints of pregnant women that occur due to physiological alterations of hormones and other causative factors which can be managed without medical interventions.”
- Every system of body may affected by pregnancy.
NURSING MANAGEMENT OF THE PREGNENT WOMEN, MINOR DISORDERS OF PREGNANCY AND MA...TanuShekhawat6
DEFINITION
During the course of pregnancy period many changes occur in a woman's body as a result of hormonal influences and adaptation to the gestational process. Thereby, they experience a variety of physiological and psychological symptoms such as nausea, vomiting, backache giddiness, heartburn and anxiety etc. These are termed as minor ailments or discomforts of pregnancy.
MINOR DISORDERS OF PREGNANCY ACCORDING TO SYSTEMS
DIGESTIVE SYSTEM
NAUSEA & VOMITING
It is a common disorder seen in about 50%women between 4th & 16th week of gestation.
Hormonal influences are thought to be the most likely cause. Human chorionic gonadotropin that is present in large amounts in the 1st trimester, estrogen & progesterone are all contribute to this.
The sickness is confined to “early morning” but can occur at any time in the day. The smell of certain cooking food will cause the symptom.
NURSING MEASURES
CONSTIPATION
Constipation is a quite common ailment during pregnancy. Atonicity of the gut due to the effect of progesterone, diminished physical activity and pressure of the gravid uterus on the pelvic colon are the possible explanations.
Whoa!
Increase the intake of water.
Add green leafy vegetables, fruits & bran cereals to her diet.
Take a glass of warm water in the morning before tea or breakfast which would activate the gut & help regular bowel movements.
Do exercise by regular walking.
HEART BURN (PYROSIS)
It occurs because the cardiac sphincter relaxes during pregnancy due to the effect of progesterone. The condition tends to worsen as pregnancy advances because the stomach is displaced upward by the enlarging uterus.
Heartburn is most troublesome at about 30th to 40th week of gestation because at this stage the stomach is under pressure from the growing uterus.
NURSING MEASURES
Avoiding aggravating factors, e.g. citrus juice, spicy & fried food.
Drink fluid before and after meals, Use Milk
Smaller meals more often.
Propped up position after meals.
Avoid lying flat.
Wear loose clothes
Antacids (Aluminum hydroxide, Magnesium hydroxide)
EXCESSIVE SALIVATION
This occurs from 8th week of gestation and it is thought that the hormones of pregnancy are the cause for it.
Hyperactivity of the parotid gland It may accompany heartburn.
Astringent mouth washes some time helpful.
Pica
This the term used when the mother craves certain foods or unnatural substances such as coal.
The cause is unknown but hormones & changes in metabolism are thought to contribute to this.
If the substances craved are harmful to the unborn baby, the mother must be helped to seek medical advice.
MUSCULO-SKELETAL SYSTEM
FATIGUE
The pregnant patient is more subjected to fatigue during the last trimester pregnancy because of altered posture & extra weight carried.
Management:
Frequent rest period should recommended.
Anemia & other systemic diseases should be ruled out.
Backache
MANAGEMENT:
Excessive weight gain should be avoided.
Rest with elevation of legs.
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comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
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2. Minor Discomforts of Pregnancy
The practical nurse is an invaluable member of the health care
team when working with pregnant patients.
Being knowledgeable and capable to support the patient and
to give her advice to make her more comfortable is very
important during the pregnancy.
Since the patient is carrying a new life within her, her body
must make certain adaptations to his presence.
These adaptations of the body can be very annoying, and by
your intervention, you may help the new pregnant patient to
carry her pregnancy more comfortably and safely.
Do be aware that all patients do not experience all of the
discomforts and some patients pass through the entire ante
partal period without any complications of this type.
3.
4. NAUSEA AND VOMITING (MORNING SICKNESS)
Due To
high levels of human chorionic gonadotropin (HCG) or
progesterone, cultural expectations,
emotional factors
hypoglycemic reaction as a result of increased basal metabolism
due to the 24-hour a day fetal and maternal body functions,
especially after a period of fasting (from night to morning).
Nausea and vomiting usually appear early in the first trimester (4 to
8 weeks) and subsides by the end of the 12th week of pregnancy.
This is most bothersome in the morning when a woman awakes and
the stomach is empty. Some pregnant women may experience this
sort of discomfort at other times of the day.
5. Nursing interventions
Reassure the mother
Eat a high-protein snack at bedtime if it's a hypoglycemic
attack.
Eat crackers or a piece of dry toast before getting up
(keep by bedside if possible).
Eat frequently spaced, small meals of high-quality
(protein) foods.
Sip a hot drink before arising.
Reduce fatty and fried containing foods.
Rest
6. Heartburn is a burning sensation in
the epigastric and sternal region.
It results from relaxation of the
cardiac sphincter and the decreased
tone and mobility of smooth
muscles .
Due to increased progesterone
thereby allowing for esophageal
regurgitation, decreased emptying
time of the stomach, and reverse
peristalsis.
Heart burn is most troublesome at
30-40 weeks gestation because at
this stage is under pressure from the
growing uterus.
NURSING INTERVENTIONS
Eat frequent, small meals.
Take sips of milk or hot tea.
Eat slowly.
Avoid fatty and gas-forming
Maintain good posture to
give the gastrointestinal tract
lots of space.
Do not lie down after eating.
sleeping with more pillows
than usual.
For persistence/sever case/
prescribe antacids.
HEART BURN (PYROSIS)
7. Pica
This is the term used
when mother craves
certain foods of
unnatural substances
such as coal, soil...etc.
The cause is unknown
but hormones and
changes in metabolism
are blamed.
NURSING
INTERVENTIONS
Seek medical advice if the
substance craved is
potentially harmful to the
unborn baby.
8. Constipation.
The gastrointestinal tract
motility is slowed
Due to
increased progesterone
resulting in increased
reabsorption of water and
drying of stool
compression of the intestines by
the enlarging uterus.
(2) Predisposition to
constipation due to oral iron
supplement (side effect of iron
therapy is constipation)
NURSING INTERVENTIONS
Drink at least six glasses of
water per day.
Increase roughage in the diet
(for example, bran, coarse
ground cereals, and fresh fruits
and vegetables with skins).
Do moderate exercise every
day, especially walking.
Maintain a regular schedule for
bowel movements.
Utilize deep breathing and
relaxation techniques.
9.
10. BACK ACHE
Nursing interventions Backache is caused by relaxation
of the sacroiliac joint
due to
increased hormones
(steroid sex hormone and
relaxing) resulting in slight
joint & muscle relaxation
and increased mobility
exaggerated lumbar and
cervico thoracic curves
caused by changes in the
center of gravity from the
enlarging abdomen and
breasts.
That maternity girdles are no
longer recommended.
To practice good posture and
good body mechanics (use the
pelvic tilt and bend at the
knees).
To wear appropriate, well-
fitting shoes.
To sleep on a firm mattress or
backboard.
That backaches may indicate a
kidney or bladder infection.
The patient must inform the
physician of backache
problems. Backaches should be
carefully evaluated.
11. Muscle Cramps.
1) Muscle cramps are caused by:
Compression of nerves supplying the lower extremities
due to the enlarging uterus.
Reduced level of diffusible serum calcium or elevation of
serum phosphorus in the bloodstream.
Fatigue, chilling, or tense body posture.
(2) Muscle cramps are not considered a serious condition,
but they may be quite painful.
12. Muscle Cramps.Nursing interventions
. Avoid fatigue and cold legs.
Eat a diet with adequate
calcium or prescribed calcium.
Avoid drinking more than one
(1) quart of milk per day. More
than one quart of milk per day
will create too much
phosphorus in the system.
Take the prescribed vitamins B
and D per doctor's instructions.
Relief of muscle cramp
TREATMENT DURING MUSCLE
CRAMPS
(a) The patient should lie on her back
and extend the affected limb. A
second individual should apply
pressure on the patient's knee
with one hand and sharply flex
the foot with the other hand . The
affected muscle may also be
kneaded with the heel or palm of
the hand.
(b) Heat may be applied to the area of
the muscle cramp.
13.
14. Supine Hypotension (Vena Cava
Syndrome)
Supine hypotension is caused by pressure of the gravid
uterus on the ascending vena cava when the woman is
supine which decreases the return of the blood.
Symptoms include nausea, cold and clammy, feels faint,
and hypotensive
16. Varicose Veins.
Varicosity is an enlargement of the lumen of a vein due to
thinning and stretching of its walls.
It is caused by the relaxation of smooth muscle walls of
veins, which is due to increased hormones (progesterone),
which causes pelvic vasocongestion.
This condition is aggravated during pregnancy due to the
enlarging uterus in the pelvis causing pressure on the great
abdominal veins, which interferes with return blood flow
from the lower extremities.
It is also aggravated by gravity and bearing down for bowel
movements. This may also be a hereditary disposition.
Varicosity involves the veins of the lower extremities (legs),
the external genitalia (vulva or labia), the pelvis, and the
Perineal area (hemorrhoids).
17. Nursing intervention
Avoid obesity.
(b) Avoid lengthy standing or
sitting.
(c) Avoid constrictive clothing.
(d) Avoid constipation and
bearing down.
(e) Elevate legs when sitting.
(f) Get adequate rest.
(g) Perform moderate exercise.
Treatment once varicose veins have
developed.
(a) Rest with legs and hips elevated.
(b) Wear support stockings before
rising (getting up) if varicose veins are
severe.
(c) Lie on the bed with legs extended
at a right angel to the body if ordered
by the physician (see figure 8-3 A).
(d) If in the vulva, may be relieved by
placing a pillow under the buttocks to
elevate the hips, assuming the Sim's
position (see figure 8-3 B) for a few
minutes several times a day, avoid
standing as much as possible, or
laying down instead of sitting when
practical.
(e) To relieve pain and swelling, take
hot sitz baths or local application of
astringent compresses (wi
18. TREATMENT ONCE VARICOSE
VEINS HAVE DEVELOPED.
Rest with legs and hips elevated.
Wear support stockings before
rising (getting up) if varicose veins
are severe.
Lie on the bed with legs extended at
a right angel to the body (A) if
ordered by the physician .
If in the vulva, may be relieved by
placing a pillow under the buttocks
to elevate the hips, assuming the
Sim's position (B) for a few minutes
several times a day, avoid standing as
much as possible, or laying down
instead of sitting when practical.
To relieve pain and swelling, take
hot sitz baths or local application of
astringent compresses .
Positions for treatment of varicose
19. Edema (Ankle Edema, Nonpitting to
Lower Extremities).
Edema is very common during pregnancy.
It most often occurs during the second and third
trimesters.
Edema is caused by reduced blood circulation in the lower
extremities as the gravid uterus puts pressure on the large
vessels.
Edema is most noticeable at the end of the day and it is
normal in pregnancy as long as it is not accompanied by the
following:
(a) Proteinuria (the presence of an excess of serum proteins in
the urine).
(b) Edema of nondependent parts.
(c) Sudden increase in weight.
(d) Hypertension.
20. Nursing intervention
Maintain good posture.
Avoid prolonged standing
or sitting.
Wear support stockings.
Avoid constrictive clothing
(garters, knee-high hose).
Drink at least eight glasses
of fluid for "natural"
diuretic effect.
Get adequate rest and
exercise; include rest
periods to elevate legs.
TREATMENT OF ANKLE
EDEMA
Elevate the feet as often as
possible.
Apply support stockings
before getting up.
Diuretics are
contraindicated.
If condition worsens to a
generalized edema, the
patient should notify her
physician
21.
22. Dyspnea.
Dyspnea is caused by the
limited expansion of the
diaphragm by the
enlarging uterus. It may
be an increased sensitivity
to or compensation for
slight acidosis ("breathing
for two").
Dyspnea may be very
troublesome in the last
weeks of pregnancy.
The patient may have
difficulty sleeping.
NURSING INTERVENTIONS
Sleep on additional pillows.
Maintain good posture.
Avoid overeating.
Stop or decrease smoking.
Limit activity before
becoming dyspenic.
Decrease anxiety by
concentrating on slow, deep
breaths.
Dyspnea of sudden onset in
patients who are known to
have heart disease may be a
sign of impending heart
failure. The physician should
be notified immediately.
23. Stuffiness
Nasal stuffiness is caused by increased vascularization
due to the increase in hormone.
It is not preventable; functioning of the nasal will
return to normal after delivery.
24.
25. Leucorrhea.
Leucorrhea is a white or
yellowish mucous discharge
from the cervical canal or the
vagina.
Caused by the hormonal
stimulation of the cervix,
which becomes hypertrophic
and hyperactive producing
an abundant amount of
mucous.
Leucorrhea is not
preventable and the patient
should not douche.
Leucorrhea may lead to
Pruritis (severe itching),
Burning on urination,
Foul odor from the discharge,
Or edema of the vulva.
NURSING INTERVENTION
Reassuring the patient
that this is normal.
Tell the patient to use
Perineal pads and to
change them frequently.
To cleanse the vulva at
least once a day with soap
and water and to dry
thoroughly.
Advising the patient to
maintain good hygiene.
26. Braxton Hicks' Contractions
These are mild,
intermittent, usually
painless, uterine
contractions.
These contractions are in
the preparation for the
work of labor
NURSING
INTERVENTIONS
That these are normal
contractions.
To get plenty of rest.
To change position as
often as possible.
To practice breathing
techniques when
contractions are
bothersome.
27.
28. Urinary Frequency and Urgency
Caused by the vascular
engorgement and altered
bladder function.
Caused by an increase in
hormones and by the
reduction of bladder
capacity.
Due to the enlarging
uterus and fetal
presenting part.
NURSING
INTERVENTIONS
That this is normal.
To limit fluid intake before
bedtime to ensure rest.
To wear Perineal pads.
Notify the physician if
pain or burning is noted.
29. Stress Incontinence
occurs later in pregnancy.
The patient may actually
void on herself.
Stress incontinence is
caused by the enlarging
uterus and pressure on the
presenting part on the
bladder.
NURSING INTERVENTIONS
Teaching the mother how to
do the Kegel exercise. The
Kegel exercise is the
alternate tightening and
relaxing of the muscles of
the perineum.
Encouraging the mother to
wear Perineal pads.
Informing the patient to
notify the physician so that
rupture of the membranes
can be ruled out.