c. Edema (Ankle Edema, Nonpitting to Lower Extremities).
(1) Edema is very common during pregnancy. It most often occurs during
the second and third trimesters. Edema is caused by reduced blood circulation in the
lower extremities as the gravid uterus puts pressure on the large vessels. Edema is
most noticeable at the end of the day and it is normal in pregnancy as long as it is not
accompanied by the following:
(a) Proteinuria (the presence of an excess of serum proteins in the
urine).
(b)
Edema of nondependent parts.
(c)
Sudden increase in weight.
(d) Hypertension.
(2)
Nursing intervention consists of advising the patient to:
(a) Maintain good posture.
(b) Avoid prolonged standing or sitting.
(c)
Wear support stockings.
(d) Avoid constrictive clothing (garters, knee-high hose).
(e) Drink at least eight glasses of fluid for "natural" diuretic effect.
(f)
Get adequate rest and exercise; include rest periods to elevate
legs.
(3)
Treatment of ankle edema.
(a) Elevate the feet as often as possible.
(b) Apply support stockings before getting up.
(c)
Diuretics are contraindicated.
(4) If condition worsens to a generalized edema, the patient should notify
her physician.
MD0921
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