Home Care - How to Relieve Severe Nausea in Pregnant Women

Home Care - How to Relieve Severe Nausea in Pregnant Women

Obstetrical Nursing  

Home Care - How to Relieve Severe Nausea in Pregnant Women

Nausea is the sensation issued a strong food or want to vomit. Vomiting sensation is accompanied by signs of autonomic, such as hypersalivation (excessive saliva expenditure), diaphoresis, tachycardia, pallor, and tachypnea. Nausea is closely linked to the occurrence of anorexia and vomiting.

Nausea can also occur due to take medication, the effects that occur after surgery and radiation. Nausea often occurs during the first trimester to a pregnant woman.
Nausea can also be caused by extreme pain due to accidents or other issues, anxiety, alcohol poisoning (drunk) because of excessive consumption, or it can also be caused by food and beverages are not tasty.

Nausea during early pregnancy is often called morning sickness, because it generally occurs in the morning. Really just happened the morning ?, Not really, because there are some pregnant women can occur at any time throughout the day. Because the exact cause is unknown, treatment of this problem can have different effectiveness. But do not worry because there are some things you can do.

Increased estrogen and thyroxine become one of the causes of nausea in pregnant women. Sometimes in some women, the nausea lasts until severe. Therefore to avoid it, you can do some of the following home care.

Get plenty of rest
When you are pregnant, you are advised to have plenty of time to rest. Rest will make your body relax and minimize fluctuation of hormones that can cause nausea.

After sleep, get up slowly
When waking from sleep, get up slowly. If you wake up suddenly, then there is a jolt that will shock your body and can make you sick.

Eating healthy food
While pregnant, avoid foods that can trigger nausea. One of them is caffeine. Caffeine is a proven bad for your pregnancy because it can increase the acid in the stomach which would exacerbate nausea.

Increase your physical activity
Physical activity you do, can reduce severe nausea because physical activity will accelerate your body's metabolic system so that you avoid nausea.

Urinary Retention in Pregnancy

Urinary Retention in Pregnancy

Urology Nursing  

Uterine incarceration is a fairly rare occurrence with an incidence of only about 1 : 3000 pregnancies. Caused by uterine retroversion him, trapped behind the sacral promontory and fixed for the remainder of the pregnancy. Between 12-20 weeks gestation, the patient will complain of lower abdominal pain, constipation, urinary incontinence, urinary retention, or even urinate constantly.

Fernandes et al (2012) noted in 10 years at a hospital in Boston occurred eight cases of uterine incarceration. The risk is spontaneous abortion. In some severe cases, the uterus may interfere with the attitude of the bladder and rectum, so as causing rupture of the bladder and rectum gangrene.

Incarceration of the uterus can lead to misdiagnosis as ectopic pregnancy, the uterus is experiencing retroflexi part, presumed gestational sac cul - de -sac while the inferior part of the uterine endometrium unexpectedly empty. Ultrasound will show that the length of the cervix appears anterosuperior position. Fundus will be in the posterior, located next to the pelvic cavity.

In a journal written on J Ultrasound Med 2012; 31:645-50, Fernandes et al revealed that the repositioning of the uterus during pregnancy should be done between 14-20 weeks old. The patient was placed with the dorsal lithotomy position, then paired urinary catheter, and hand pressed bimanually the uterus. One finger went into the rectum, and then increase the pressure on the uterus. If difficult to do with regional anesthesia, this procedure can be performed laparoscopically or even laparotomy. Having returned to the position anteflexi uterus, uterine pessarium fitted for a week in order not to go back into retroversion.

7 Minimum Standards of Antenatal Care

7 Minimum Standards of Antenatal Care

Obstetrical Nursing  

Antenatal Care (ANC) is a prenatal care provided by a midwife or doctor to the mother during pregnancy to optimize mental and physical health of pregnant women, so as to face childbirth, childbirth preparation, breastfeeding, and the return of normal reproductive health (Manuaba, 1998) .

Antenatal antenatal examination is done to check on the mother and fetus at regular intervals, followed by efforts to correct the deviations found (Antenatal Care Guidelines on Basic Service Level, 2004: 1).

7 Minimum Standards Antenatal Care

According to Saifuddin (2002) Antenatal care covers a lot of things, but in the application of the minimum standards of known operations consist of:

1. Measure weight
During pregnancy is between 0.3-0.5 kg per week. When gestational age was associated with weight gain during early pregnancy ± 1 kg, then the second and third trimester, respectively increases of 5 kg. At the end of pregnancy weight gain total is 9-12 kg. If there is excessive weight gain should be considered towards the risk as swelling, multiple pregnancy, hydramnios, and a great kid.

2. Measure blood pressure
During pregnancy, high blood pressure when more than 140/90 mmHg. When blood pressure increases, ie 30 mmHg systolic or more and or diastolic 15 mm Hg or more. These abnormalities may progress to preeclampsia and eclampsia if not handled properly.

3. Measure the height of fundus of uterus

Normal fundus height is as follows:
12 weeks: 1-2 fingers above the symphysis.
16 weeks: halfway between the symphysis-center.
20 weeks: 3 fingers under center.
24 weeks: tall center.
28 weeks: 3 fingers above the center.
32 weeks: mid-center - processus xiphoideus.
36 weeks: three fingers below the processus xiphoideus.
40 weeks: midway between the processus xiphoideus - center (Mochtar, 1998)

4. TT immunization
Giving TT, will lead to a protective effect when given at least twice with a minimum interval of 4 weeks. Except if the mother had previously received TT twice in the last pregnancy or at the time of the TT pretty bride was given only once.

5. Provision of iron tablets
Basically giving iron tablets initially treated with a single daily tablet as soon as possible after the nausea passes.

6. Tests for sexually transmitted diseases.
During pregnancy, mothers should be tested for sexually transmitted diseases such as HIV / AIDS, Gonorrhoe, syphilis. That is because very influential on the fetus. If found disease - sexually transmitted diseases should be addressed.

7. Counseling
Preparation refers to higher health care, need to be prepared because the maternal and infant mortality due to delay in reaching health facilities.

Headaches During Pregnancy - Prevention and Pain Management

Headaches During Pregnancy - Prevention and Pain Management

Pain Management  

Headaches experienced during the first trimester due to the rapidly changing hormone levels, resulting in increased blood volume in the body. In addition, feelings of stress which is often plagued pregnant women is also one of the triggers of these symptoms. There are several types of headaches that can occur during pregnancy. One of them is feeling like a squeezing pain on both sides of the head or the back of the neck.

Many women who experience tension headaches during pregnancy and this may become more severe during the first trimester. This type of headache is usually caused by lack of sleep and depression during pregnancy. However, the increased levels of the hormone can also be one cause.

Mothers who are pregnant should not take carelessly known cure for fear of affecting the fetus in the womb. Most of headache medications may have harmful effects or unknown impact on infant development.


Prevention

For that to know a few things that can prevent the occurrence of headaches during pregnancy :

1. Avoiding triggers, various things are known can be a trigger like eating late, certain smells or foods consumed.
2. Physical activity in your daily routine, such as walking every day or doing light aerobic exercise.
3. Perform relaxation exercises, soothing activities such as yoga, deep breathing and visualization can help keep headaches.
4. Eat small meals but more frequently, so they can keep blood sugar levels stable and prevent headaches. If you do not eat for 2-3 hours, a quick snack consumption, such as biscuits. This will immediately raise blood sugar levels.
5. Consume enough fluids to keep the body well hydrated. Immediately drink water or juice.
6. Maintain a regular sleep schedule, due to fatigue and lack of sleep can contribute to headaches during pregnancy, and be sure to go to bed and wake up at the same time even on weekends.
7. Maintain good posture, due to poor posture or muscle tension can cause headaches, especially the weight gain to support the pregnancy.
8. First of all, sit down first. This method helps reduce the pain (because blood flow to the head so much smoother), also prevents falling pregnant women.
9. If it will change the position of the body, do it slowly. For example, if you stand up from a lying position, try to sit down, then stand slowly.

But if the inevitable headaches and attacking pregnant women , then do the following steps :

1. Do the rest by lying in a dark room or dim , quiet atmosphere and eyes closed .
2. Using warm compresses to the eyes , face and temples or forehead , or could also try a cold compress on the back of the neck .
3. Ask someone to do massage on the shoulders and neck to relieve tension , or massaging the temples also can help . Actually , headache disorders are not severe .

But , if the second trimester headaches for the first time ( both with impaired vision or not , abdominal pain , skyrocketing weight gain , and swelling of the face or hands ) , soon to consult a midwife or a doctor . Could be , blood pressure and urine should be examined in the laboratory to see the possibility of developing pre - eclampsia or pregnancy poisoning . This is also the reason for the importance of antenatal care on a regular basis .

Imbalanced Nutrition related to Hyperemesis Gravidarum

Imbalanced Nutrition related to Hyperemesis Gravidarum

Obstetrical Nursing  

Nursing Care Plan for Hyperemesis Gravidarum - Nursing Diagnosis : Imbalanced Nutrition: less than body requirements

Hyperemesis Gravidarum

Nausea and vomiting (emesis gravidarum) is a natural phenomenon and is often caught in the first trimester of pregnancy. Nausea usually occurs in the morning, but can arise at any time and at night. These symptoms occur approximately 6 weeks after the first day of the last menstrual period and lasts for approximately 10 weeks. Nausea and vomiting occur in 60-80% primi gravida and 40-60% multi gravida. One in every thousand pregnancies, these symptoms become more severe.

Nausea is largely attributable because of increased levels of estrogen and HCG (Human Chorionic Gonadrotropin) in serum. Physiological effect of the hormone increase is not clear, probably because the central nervous system or the gastric emptying of the stomach is reduced. In general, women can adapt to this situation, though symptoms of severe nausea and vomiting that can last up to 4 months. Daily work was interrupted, and the general condition became worse. This condition is called hyperemesis gravidarum. Complaints of symptoms and physiological changes determine the severity of the disease. (Prawirohardjo, 2002)

Hyperemesis gravidarum is defined as excessive vomiting or uncontrolled during pregnancy, which causes dehydration, electrolyte imbalance, or nutritional deficiencies, and weight loss. The incidence of this condition is approximately 3.5 per 1000 births. Although most cases of missing and disappeared over time, one out of every 1,000 pregnant women will undergo hospitalization. Hyperemesis gravidarum usually disappear on their own (self-limiting), but healing is slow and frequent relapses are common. The condition often occurs among primigravida women and tends to recur in subsequent pregnancies. (Lowdermilk, 2004).


Nursing Diagnosis for Hyperemesis Gravidarum : Imbalanced Nutrition: less than body requirements related to excessive frequency of nausea and vomiting.

Nursing Intervention for Hyperemesis Gravidarum

1. Limit oral intake until the vomiting stops.
R /: Maintain electrolyte fluid balance and prevent further vomiting.

2. Give anti-emetic drugs are prescribed at low doses.
R /: Preventing vomiting and maintain fluid and electrolyte balance.

3. Maintain fluid therapy is programmed.
R /: Correct the hypovolemia and electrolyte balance.

4. Record intake and output.
R /: Determining hydration fluids through vomiting and spending.

5. Anjurjan eat small meals but often.
R /: Can adequate intake of nutrients your body needs.

6. Instruct to avoid fatty foods.
R /: to stimulate nausea and vomiting.

7. Instruct the patient to eat a snack such as biscuit, bread and hot tea before getting out of bed during the day and before bed.
R /: Food distraction can reduce or avoid excessive excitatory nausea vomiting.

8. Record intake, if oral intake can not be given within a certain period.
R /: To maintain a balance of nutrients.

9. Inspection of an irritation or lesions in the mouth.
R /: To determine the integrity of the oral mucosa.

10. Assess oral hygiene and personal hygiene as well as the use of oral cleaning fluids as often as possible.
R /: To maintain the integrity of the oral mucosa.

11. Monitor hemoglobin and hematocrit.
R /: Identify the potential anemia and decreased oxygen-carrying capacity of the mother.

12. Test urine for acetone, albumin and glucose.
R /: Establish baseline data; performed routinely to detect potential high-risk situations such as the inadequate intake of carbohydrate, diabetic and hypertension due to pregnancy ketoasedosis.

13. Measure uterine enlargement.
R /: Malnutrition affects maternal fetal growth and aggravate komplemensel decrease in fetal brain, resulting in deterioration of fetal development and the possibilities further.

Risk for Infection related to Premature Rupture of Membranes

Risk for Infection related to Premature Rupture of Membranes

Risk for Infection  

Nursing Care  Plan for Premature Rupture of Membranes

Premature rupture of membranes (PROM) is a rupture (breaking open) of the membranes (amniotic sac) before labor begins. If PROM occurs before 37 weeks of pregnancy, it is called preterm premature rupture of membranes (PPROM).

PROM occurs in about 8 to 10 percent of all pregnancies. PPROM (before 37 weeks) accounts for one fourth to one third of all preterm births.

The management of PPROM is among the most controversial issues in perinatal medicine. Points of contention include:

• Expectant management versus intervention
• Use of tocolytics
• Duration of administration of antibiotic prophylaxis
• Timing of administration of antenatal corticosteroids
• Methods of testing for maternal/fetal infection
• Timing of delivery.

Risk Factors and Causes:

Certain types of infections appear to be able to cause preterm PROM, and in rare cases procedures such as amniocentesis can cause PROM, but researchers do not believe there is a single cause of the condition. The following are some known risk factors:

• Lower socioeconomic status
• history of PPROM
• bleeding during pregnancy
• Smoking
• Prior preterm birth
• Sexually transmitted diseases
• Multiple pregnancy
• Polyhydramnios

The following are the most common symptoms of PROM. However, each woman may experience symptoms differently. Symptoms may include:

• Leaking or a gush of watery fluid from the vagina
• Constant wetness in underwear

If you notice any symptoms of PROM, be sure to call your doctor as soon as possible. The symptoms of PROM may resemble other medical conditions. Consult your doctor for a diagnosis.


Nursing Diagnosis for Premature Rupture of Membranes : Risk for Infection related to invasive procedures, recurrent vaginal examination, and amniotic membrane rupture.

Goal: maternal infection does not occur

Expected outcomes: Mother states / shows are free of any signs of infection.

Nursing Interventions for Premature Rupture of Membranes:

1. Perform initial vaginal examination, when the contraction pattern repeat, or maternal behavior indicates progress.
R /: Repeated vaginal examinations play a role in the incidence of ascending tract infections.

2. Monitor temperature, pulse, respiration, and white blood cells as indicated.
R /: Within 4 hours after membrane rupture, chorioamnionitis incidence increased progressively in accordance with the time indicated by vital signs.

3. Give prophylactic antibiotics when indicated.
R /: Antibiotic may protect against the development of chorioamnionitis in women at risk.