Question

Emma Halleck is a 21-year-old White female who presented at the antepartum clinic on June 15. She suspects that she is pregnant: A home pregnancy test was positive. Her last menstrual period began on April 10. She reports having urinary frequency, breast tenderness, fatigue, and occasional nausea and vomiting. She has begun to have some light headedness and dizziness when she first gets up after sitting or sleeping.

Ms. Halleck tells you she is married and states that this is her second pregnancy. She miscarried at 10 weeks approximately 6 months ago. She denies any history of drug or alcohol use, sexually transmitted infections (STIs), multiple partners, family violence, medical-surgical disorders, or mental illness. Ms. Halleck is excited about the pregnancy, and she reports that her husband is too. She does express concern over carrying the pregnancy to term, although she feels relieved that she is beyond the time of her first pregnancy loss. This pregnancy was a planned pregnancy. Ms. Halleck is a college graduate, employed as a teacher, and has group health insurance through the local public-school system.

Exam

Weight 122 lb. (prepregnant weight usually between 115 and 120 lb.)

Height 5'4"

BP 110/60 mmHg, P 82 bpm, R 16/min

Hb 12, Hct 33%, WBC 5000

UA, blood glucose, and protein all negative

Rubella titer—within normal limits

HIV, STIs—negative

Hepatitis antibody—negative

Immunoassay pregnancy test—positive

Mother: O Rh negative; father: O Rh positive

On pelvic exam, the physician determines that Ms. Halleck’s uterus is enlarged and at the top of the symphysis pubis. The lower uterine segment is soft; the cervix is soft and bluish in color. There is an increase in vaginal and cervical secretions. The physician determines that Ms. Halleck’s pelvis is adequate for a normal vaginal birth. Vaginal ultrasound confirms pregnancy with fetal heart tones at 120 beats per minute.

Question 1

Why is Mrs. Halleck experiencing urinary frequency?

Question 2

Why is Mrs. Halleck having breast tenderness at this time?

Question 3

Are light-headedness and dizziness normal? Why or why not? What nursing intervention should be taught to all pregnant women to avoid these symptoms?

Answer 1

Answer 1)

It is a symptom of pregnancy occurring due to increased glomerular filtration rate and increased intravascular volume.Along with this there is compression of urinary bladder causing frequency of urination

Answer 2)

Breast tenderness also occurs in first trimester because of hormonal changes

Answer 3)

Light headedness and dizziness occurs because of increased blood volume and hormonal changes.It is normal

Some nursing interventions to be taught to all pregnant women are

• No over exertion
• No long standing
• Not to get up suddenly from sitting or lying down position
• If feeling dizzy immediately sit or lie down
• Increase liquid intake
• Not to take stress
• Use relaxation techniques for headache
• Eat small frequent meals
• Not to stay hunger
• Simple headache relief me as like applying herbal ointment for headache