OB- Common Pregnancy Complaints

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Anonymous
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219502
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OB- Common Pregnancy Complaints
Updated:
2013-05-13 21:40:18
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OB
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  1. List 6 management strategies for H/A in pregnancy.
    • 1. Tylenol 650mg Q4hr PRN (take early)
    • 2. Avoid dietary triggers (chocolate, MSG, nitrates)
    • 3. Avoid skipping meals
    • 4. Avoid stimuli in environment
    • 5. Adequate rest and sleep
    • 6. Massage, moist heat/cold to back of neck
  2. What are 4 possible causes of constipation in pregnancy?
    • 1. progesterone (relaxes)
    • 2. mechanical obstruction
    • 3. Increased fluid absorption from GI tract
    • 4. Iron supplements
    • ***change in activity, excess Ca+, antihistamines
  3. What do you want to rule out with a pregnant woman presenting w/ constipation?
    -bowel obstruction, appendicitis, IBS
  4. What are some management options for constipation?
    • 1. high fluid/fiber intake
    • 2. bulk laxatives
    • 3. stool softeners
    • 4. time-released Fe
    • 5. warm beverages
    • 6. establish regular bowel routine
    • 7. exercise
  5. T or F.  Laxative and enemas are appropriate management for constipation in pregnant women?
    no
  6. What are 3 sources of management options to treat hemorrhoids during pregnancy?
    • 1. Steroids (anusol, Prep H)
    • 2. Topical (sitz, ice packs, salt bath, tucks)
    • 3. systemic (mineral oil, stool softeners)
  7. T or F.  Nose bleeds occur mostly in the 3rd trimester?
    False. Occurs in all 3 Trimesters
  8. What are 3 causes of epistaxis during pregnancy?
    • 1. Estrogen--> vasodilation of mucous membranes
    • 2. progesterone--> relaxation of vein walls
    • 3. Blood vessel engorgement
  9. When is dyspnea most prevalent during pregnancy?
    Late 2nd and all 3rd TM ( caused by elevation of diaphragm and increased CO)
  10. What should you rule out or look for with a pregnant lady presenting w/ dypsnea?
    • 1. URI
    • 2. COPD/asthma
    • 3. Cardiac d/o
    • 4. TB
    • 5. Hemptysis
    • 6. fever
    • 7. cyanosis
    • 8 retractions
  11. What are some management options for pregnant women with dyspnea?
    • 1. Sleep (increase HOB, lay on side)
    • 2. Rest (after exercise)
    • 3. Avoid tight clothing
  12. When is urinary frequency most common during pregnancy?
    1st and 3rd TM
  13. What should you consider or rule in a pregnant patient with urinary frequency?
    -UTI/asymptomatic bacturia
  14. What are some management options for urinary frequency?
    • 1. Reassurance
    • 2. decrease caffeine/ETOH
    • 3. Kegel
    • 4. Frequent voids to avoid UTI
    • 5. Review S/S of UTI
    • 6. possibly panty liner
  15. When is fatigue a major complaint during pregnancy?
    During all TM but worst in 3rd TM
  16. What should you rule out for fatigue in pregnancy?
    • 1. infection
    • 2. inadequate nutrition
    • 3. anemia
    • 4. PIH
    • 5. Depression
    • 6. anxiety
    • 7. stress
    • 8. cardiac/pulm problems
  17. When is dizziness most commonly seen during pregnancy?
    -1st/3rd TM

    Caused by vasomotor instability, hypoglycemia, or later vena caval compression
  18. How much water should be recommended for a pregnancy woman to drink daily?
    3 quarts
  19. When are complaints of nausea most prevalent in pregnant women?
    1st/3rd TM
  20. What are some causes of nausea during pregnancy?
    • 1. Reflux
    • 2. Elevated HCG
    • 3. Progesterone smooth muscle relaxation
    • 4. Increased gastric emptying time
    • 5. Lower functional reserve of liver capacity
    • 6. hypoglycemia
    • 7. psychological stress
    • 8. 3rd TM: relaxatio of cardiac sphincter
  21. What are some management options for pregnant women w/ nausea?
    • -keep track of intake/output
    • -avoid meal preparation
    • -Dietary adjustments like small frequent meals, room temp foods, crackers b/f rising, fluids between meals and not with meals
    • -Monitor: ketones, weight, specific gravity
    • -Herbals: ginger root, peppermint, chamomile, raspberry leaf
  22. What are some medical management options for nausea during pregnancy?
    • -Zofran 4-8mg TID
    • -Emetrol upon waking, repeat q 3-4hr
    • -Reglan 10mg TID
    • -Doxylamine succinate (unisom) w/ Vit B6
    • -Phenergan 1/4 tab QID
  23. When are wrist/hand complaints most common during pregnancy?
    2nd/3rd TM
  24. What are some management options for wrist/hand pain?
    • -Avoid fine motor activities
    • -frequent rest with fine motor  activities
    • -wrist brace/cock-up splint
    • -cortisone injections
  25. When is Leukorrhea most prevalent during pregnancy?
    Throughout pregnancy
  26. What should you rule out with Leukorrhea?
    vaginitis and PROM
  27. What should you rule out with back pain?
    • 1. Pyelonephritis
    • 2. UTI
    • 3. Preterm labor
    • 4. Disc problems
    • 5. Ortho problems
  28. What are 3 causes of sciatica pain during pregnancy?
    • 1. Shifting of pelvic bone
    • 2. Relaxed ligaments
    • 3. Fluid retention
  29. What are some management options for leg cramps during pregnancy?
    • 1. Reduce Phos/increase Ca
    • 2. Dorsiflex foot
    • 3. Compress muscle/massage
    • 4. apply warm compresses
    • 5. Keep legs warm
    • 6. Avoid heels
    • 7. support hose
  30. What are some management options for varicosities?
    • -Support hose
    • -elevate legs
    • -Avoid: prolonged standing, constrictive clothing, crossing legs at the knee, sitting for more than 1 hr
    • -Vulvar support like a pad

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