Transcript Anticipatory Guidance During Pregnancy

Anticipatory Guidance
During Pregnancy
By
Catherine Ramos Marin,
MSN/Ed(c), WHCNP, RN
First Trimester (1-13 weeks)
Discomforts of pregnancy (N/V, frequent
urination)
 Increase sleep needs (8 hrs./day)
 Exercise (fine as long as the client is able
to converse easily whle exercising)
 Work: no exposure to hazardous
chemicals or toxins
 Ingest no medication, no alcohol/drugs
and to stop smoking
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Second Trimester (14-26 weeks)
Sexual needs and desire: encourage
communication b/w husband and wife
 Regular dental check-up: maintain dental
hygiene, delay radiographs and major
dental work if possible (gum hypertrophy
is common)
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Third Trimester (27 weeks to 40 weeks)
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Schedule childbirth classes
Increase urinary frequency and dyspnea
Review interventions on leg cramps, nasal
stuffiness, varicose veins, and constipation
Breastfeeding teachings
Choosing pediatrician and clinic
Nutritional needs: period of rapid fetal growth
Teach s/s of preterm labor
Teach danger signs of pre-eclampsia and
eclampsia
Nutritional Teachings
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Increase intake by 300 calories above
basal and activity needs
Increase protein by 30 gm/day
Increase intake of Iron (30+ mg) and
folic acid (800 to 1000 mcg) through diet
and supplements
Increase intake of Vitamin A, Vit. C and
calcium through diet
Weight Gain
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2-4 lbs. in the 1st trimester is considered
normal
0.9 lb./week thereafter
Is normal (> 2 lbs/week may be related
to pre-eclampsia: edema
Total weight gain during pregnancy: 2535 lbs.
Substance Abuse During Pregnancy
Smoking: low birth weight infant
 Alcohol: fetal alcohol syndrome
 Cocaine: preterm labor and abruptio
placenta
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Teach that teratogenic fetal effects are
highest in the first trimester
Anemia during Pregnancy
A decrease in the oxygen carrying
capacity of blood
 Often related to Iron deficiency and
reduced dietary intake
 Occurs in 20% of pregnant women
 Associated with increase incidence of
abortion, PTL, pre-eclampsia
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Anemia
Hgb < 11 g/dl, Hct < 37 % during 1st
trimester
 Hgb <10.5 g/dl, Hct < 35% during 2nd
trimester
 Hgb <10 g/dl, Hct < 32% during 3rd
trimester
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Nursing Interventions
24 hr. dietary recall
 Oral administration of Iron
 Teach nutritional requirements
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Oral Administration of Iron
Best absorbed on an empty stomach
 Taken with Vit. C such as OJ to increase
absorption
 Take in the evening if problem exist w/
morning sickness
 Stools will turn dark green to black
 Lab values should be checked for
increased reticulocytes and rising Hgb and
Hct
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Teenage Adolescent Pregnancy
Pregnancy at age 19 or younger
 Highly associated with anemia, preeclampsia, CPD, STDs, IUGR, and
ineffective parenting
 Assess: Nutritional status (24 hr. diet
recall), attitude toward pregnancy and
becoming a mother, social support system
(family, spouse, BF, friends), domestic
violence, peer activities (smoking, drugs,
alcohol), economic status, educational
status, access to prenatal care
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