MARK ANDREW CASTELO GAERLAN PRENATAL Health Teachings: Symptom Cause Health Teaching 1.

Nausea & Vomitting Increased HCG. Dry crackers 30 mins before arising. Small, frequent meals, low fat. Liquids between meals Avoid anti-emetics. 2. HEARTBURN Increased progesterone which Pats of butter before meals. decreases gastric motility causing Avoid fried, fatty foods. esophageal reflux. Give small, frequent meals. Sips of meals at frequent intervals. Bends at the knees, not at the waist. Take antacids. 3. CONSTIPATION Displacement of the stomach & Increase fluids & roughage at the diet. intestines; Iron supplements. Regular elimination time. 4. LEG CRAMPS Increase pressure of gravid Frequent rest, with feet elevated. uterus; Low Calcium. Regular exercise like walking. Increase milk intake. 5. ANKLE EDEMA From venous stasis. Elevate legs at least twice/day. Sleep on left side. 6. VARICOSE VEINS From faulty valves or weakened Elevate feet while sitting. walls of blood vessels. Use support hose. Apply elastic bandage. Avoid use of constricting clothes. 7. Hemorrhoids Increase venous pressure of Warm sitz bath. growing fetus. High fiber & liquid diet Sit on pillow. 8. Urinary Frequency Pressure of enlarged uterus on Sleep on the side at night. kidneys Limit fluid intake on the evening. 9. Backache From exaggerated lumbosacral Pelvic rock exercise, No weight lifting. curving Wear low-heeled shoes 10. Shortness of Breath From pressure on diaphragm Sleep with feet elevated or on regularly 11. Breast Tenderness Increase estrogen & progesterone. Wear well fitted bra; Warm compress DONTS Smoking Drinking Alcohol Drugs (esp on 1st Trimester) Thalidomide Steroids Streptomycin Aspirin Tetracycline Cocaine Narcotics Amphetamines Sexual Activity Cause vasoconstriction, leading to Low Birth Weight babies. When excess causes respiratory depression in newborn & fetal withdrawal syndrome. Delayed Fetal Growth & Development Amelia or Phocomelia (short or no extremities) Cleft palate & abortion. Damage to 8th Cranial Nerve (poor hearing) Bleeding disorder Staining of tooth enamel Abruptio placenta, preterm labor, fetal death. Small for Gestational Age babies. Jitterness & poor feeding at birth. In moderation but not during the last 6 weeks due to postpartum infection risk.

Travelling

Exercise INTRAPARTAL Health Teachings: First Stage of Labor: 1. Headache: Take BP *If within normal- allow mother to rest. *If above normal- refer to physician 2. Encourage mother to bathe. 3. NPO- GIT stops during labor and may cause aspiration & vomiting. 4. Enema (as ordered): To cleanse the bowel & prevent infection. *Position: Side-lying or Lateral sims *Check FHT after enema. (Normal: 120-160, irregular) 5. Maintain on Left Lateral position to prevent Supine Hypotension or Supine Vena Caval Syndrome. Second Stage of Labor: Place legs up in lithotomy simultaneously (to prevent trauma to uterine ligaments) Advice mother to do panting, breathing exercise like blowing a feather. Push with an open glottis to prevent hypotension. Prevent hyperventilation which can lead to respiratory alkalosis. POSTPARTUM Health Teachings 1. Breast Feeding

Dont travel during the last trimester. On long rides, 15-20min rest period every 2-3 hours. In moderation, to strengthen the muscles used in labor & delivery.

2. Breast Dicomforts/ Engorgement

3. Cracked Nipples

4. Difficulty Voiding

5. Constipation 6. Lochial Changes

7. Episiotomy

8. Homans sign (Pain in the calves)

Wash breast daily at bath or shower time Wear Supportive bra Wash hands before and after every feeding Insert clean gauze or clothing in brassiere to absorb moisture. Breastfeed frequently Apply warm packs before feeding Apply ice packs between feedings Pumping or manually expressing breast milk Expose nipples to air 10-20 mins after feeding Rotate the position of baby on each feeding. Be sure the baby is latched on the areola, not just the nipple. Pour warm & cool water over the vulva Let her listen to the sound of running water. Avoid constrictive clothing Perform Kegels exercise. Adequate fluid intake, proper diet, & regular defecation time. Adequate dietary fiber; if necessary give stool softeners, laxatives Report abnormal progressions of lochia, excessive bleeding, foulsmelling, & large blood clots. Avoid sexual contact Place on Sims position Perineal heat lamp or warm sitz bath 2x/day Do perienal care flush with warm water. Administration of topical analgesics or mild oral analgesics. Ambulate as soon as possible to avoid thombi formation Do not cross legs for long periods of time. Elevate legs while sitting.