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 (Table 8-1) and some
patients pass through the entire antepartal period without any complications of
DISCOMFORTS RELATED TO THE GASTROINTESTINAL SYSTEM
a. Nausea and Vomiting (Morning
(1) One of the most common discomforts of early pregnancy is
possibly due to high levels of humanchorionic gonadotropin (HCG) or
progesterone, cultural expectations, emotional factors, and 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).
(2) Nausea and vomiting usually appear early in the first
trimester (6 to 8 weeks) and subsides by the end of the 12th week of
(3) 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.
(4) Nursing interventions consist of advising the mother to:
(a) Eat a high-protein snack at bedtime if it's a
(b) Eat crackers or a piece of dry toast before getting up
(keep by bedside if possible).
(c) Eat frequently spaced, small meals of high-quality
(d) Sip a hot drink before arising.
pregnancy-related ailment is caused by leaking of stomach acid into
an unprotected esophagus, causing a chemical burn known as
heartburn. The best relief is obtained by sucking on an antacid
tablet until the pain goes away (one or two tablets).
Zantac 75, or
Prilosec OTC can also be used safely during pregnancy.
b. Heartburn (Pyrosis).
(1) 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 which is due to increased
progesterone thereby allowing for esophageal regurgitation, decreased emptying
time of the stomach, and reverse peristalsis.
(2) Nursing interventions consist of advising the patient to:
(a) Eat frequent, small meals.
(b) Take sips of milk or hot tea.
(c) Eat slowly.
(d) Avoid fatty and gas-forming foods.
(e) Maintain good posture to give the gastrointestinal tract
lots of space.
(f) Do not lie down after eating.
(1) The gastrointestinal tract motility is slowed due to
increased progesterone resulting in increased reabsorption of water and drying
of stool; and compression of the intestines by the enlarging uterus.
(2) Predisposition to constipation due to oral iron supplement
(side effect of iron therapy is constipation). Some patients respond with
(3) Nursing intervention consists of advising the patient to:
(a) Drink at least six glasses of water per day.
(b) Increase roughage in the diet (for example, bran, coarse
ground cereals, and fresh fruits and vegetables with skins).
(c) Do moderate exercise every day, especially walking.
(d) Maintain a regular schedule for bowel movements.
(e) Utilize deep breathing and relaxation techniques.