(5) Implement prophylactic measures (lotions, massages, op-site) to
prevent skin breakdown.
(6) Be alert to the psychological needs of the patient. She may be
concerned about this crisis and of the results on herself and the fetus.
a. Heartburn is a burning sensation in the epigastric and sternal region. It
results from relaxation of the cardiac sphincter and the decreased tone and mobility of
smooth muscles due to increased progesterone, thereby allowing for esophageal
regurgitation, decreased emptying time of the stomach, and reverse peristalsis.
Heartburn has nothing to do with the heart. It occurs more frequently as pregnancy
advances as a result of decreased peristalsis and pressure of the growing fetus on the
b. Nursing interventions consist of advising the patient to:
(1) Not to lie flat after eating. Sitting or walking helps gravity move the food
through the gastrointestinal tract.
(2) Drink a glass of milk about 1/2 hour before eating. This will inhibit the
secretion of stomach acid.
Avoid eating or drinking gas-forming foods or fluids (cabbage, beans,
(4) Not take any antacid unless ordered by her obstetric (OB) practitioner
or physician. Sodium bicarbonate and Alka-SeltzerTM contain high amounts of sodium.
Eat small, frequent, non-spicy, non-fried meals and drink adequate
a. There are many types of infection which the patient can contact during
pregnancy. However, the most prevalent infections are urinary track infections,
venereal diseases, and human immunodeficiency virus (HIV).
(1) Urinary track infections. Infections of the urinary track are common
during pregnancy. The infections are caused by the narrowing of the lower urethra and
dilation of the upper urethra. This action results in a slowing of urination, which
increases the risk of infection.