Chapter 16
The Expectant Family: Needs and Care
Resource Library
Prentice Hall Nursing Medialink DVD-ROM
AudioGlossary
NCLEX Review
Videos: Through the Eyes of a Nurse—The First Trimester; Through the Eyes of a Nurse—The
Second Trimester; Through the Eyes of a Nurse—The Third Trimester
Companion Website
Additional NCLEX Review
Case Study: First Trimester Client
Care Plan Activity: Common Discomforts of Pregnancy
Applications: Teaching Resources for Pregnant Couples; Exercise
During Pregnancy; Smoking Cessation Plan; Fetal Alcohol
Syndrome
Critical Thinking
Learning Objective 1
Describe the significance of using the nursing process to promote
health in the woman and her family during pregnancy.
Concepts for Lecture
1. Nursing Process
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Assessment data every 4 to 6 weeks
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Ensure continuity of care
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Expected nursing diagnoses, goals, and interventions
Learning Objective 2
Describe actions the nurse can take to help maintain the well-being of the expectant father and
siblings during a family’s pregnancy.
Concepts for Lecture
1. Goals for Family Management
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Improvement in
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Problem-solving ability
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Self-esteem
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Self-confidence
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Ability to participate in health care
2. Nurse-Family Interventions
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Father
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Assess role
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Anticipatory guidance
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Provide information about pregnancy changes
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Guidance about couple’s sexuality during pregnancy
3.Nurse-Family Interventions
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Siblings
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Encourage involvement in pregnancy
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Emphasize open parent-child communication
Learning Objective 3
Discuss the significance of cultural considerations in managing nursing care during pregnancy.
Concepts for Lecture
1. Cultural Considerations
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Cultural assessment
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Using nursing process
°
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Adapt to client needs
Transcultural nursing diagnosis
Cultural competence
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Recognition of influence of culture and life experiences
Learning Objective 4
Explain the causes of the common discomforts of pregnancy.
Concepts for Lecture
1. Common Discomforts: First Trimester
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Nausea and vomiting
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Urinary frequency
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Fatigue
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Breast sensistivity
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Leukorrhea
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Nasal stuffiness and discharge
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Nosebleeds
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Pytalism
2. Common Discomforts: Second and Third Trimesters
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Heartburn
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Ankle edema
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Varicose veins
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Flatulence
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Hemorrhoids
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Constipation
3. Common Discomforts: Second and Third Trimesters
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Backache
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Leg cramps
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Feeling faint
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Shortness of breath
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Sleep disturbances
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Round ligament pain
Suggestions for Classroom Activities
Have groups of students present a common discomfort of pregnancy to the class, including the
causes and management of the discomfort.
Learning Objective 5
Summarize appropriate measures to alleviate the common discomforts of pregnancy.
Concepts for Lecture
Alleviating Discomforts
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Urinary frequency
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Fatigue
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Napping
Breast tenderness
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Safety considerations at home
Wear supportive bra
Increased vaginal discharge
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Nasal stuffiness
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Avoid constipation, gently self-reduce hemorrhoid
Constipation
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Avoid gas-forming foods, regular bowel habits
Hemorrhoids
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Regular exercise, avoid prolonged sitting or standing
Flatulence
°
•
Avoid prolonged sitting or standing, keep feet and legs elevated
Varicose veins (Figure 16.4)
°
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Avoid fried and fatty foods, eat small frequent meals, good posture
Ankle edema
°
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Cool air vaporizers, normal saline nasal spray
Heartburn
°
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Daily bathing, cotton underwear, avoid douching
Increase fluids and roughage, daily exercise, regular bowel habits
Backache
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Pelvic tilt exercise, good posture, avoid fatigue, good body
mechanics when lifting
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Leg cramps
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Massage, warm soaks, stretching exercises
Faintness
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Sit down and lower head between knees, avoid standing in one
place too long
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Shortness of breath
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Good posture when sitting, prop up in bed
Difficulty sleeping
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Avoid caffeine, maximize comfort in bed
Learning Objective 6
Delineate self-care actions a pregnant woman and her family can take to maintain and promote
well-being during each trimester of pregnancy.
Concepts for Lecture
1. Self-Care During Pregnancy
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Breast care
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Supportive bra
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Cleanliness
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No soap on nipples
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Nipple preparation (Figure 16.8A–C)
Clothing
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Loose and nonconstricting
Cleanliness
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Daily bathing
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Tub baths contraindicated with vaginal bleeding or ruptured
membranes
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•
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Hyperthermia contraindicated in first trimester
Employment
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Can work until labor starts
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jobs
May be at risk for preterm birth or low birth weight with certain
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Must be aware of environmental hazards
Travel
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No restrictions unless complications
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Frequent breaks during car travel
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Use seat belt
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Flying safe up to 36 weeks
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Drink plenty of fluid
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Avoid caffeinated beverages
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Wear support hose while flying
2. Benefits of Exercise
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Improved self-image
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Increases energy
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Improves sleep
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Relieves tension
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Helps control weight gain
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Promotes regular bowel function
3. Pregnancy Exercises
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Pelvic tilt (Figure 16.11C)
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Abdominal exercise
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Kegel exercise (Figure 16.13)
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“Tailor-sit” stretch
Learning Objective 7
Identify some of the concerns that an expectant couple may have about sexual activity.
Concepts for Lecture
1. Concerns About Sexual Activity
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Related to discomforts
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First trimester—fatigue, nausea, and vomiting
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Second trimester—fewer discomforts, vascular congestion
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Third trimester—fatigue, shortness of breath, decreased mobility
2. Father’s Feelings About Sex
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Affected by
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Previous relationship with the partner
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Acceptance of the pregnancy
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Attitudes toward the partner’s change of appearance
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Concern about hurting the expectant mother or baby
Learning Objective 8
Describe factors that have contributed to the increased incidence of pregnancy in women over
age 35.
Concepts for Lecture
1. Factors Contributing to Pregnancies over 35
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The availability of effective birth control methods
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The career options available for women
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The increased number of women
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Obtaining advanced education
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Pursuing careers
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Delaying parenthood
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The increased incidence of later marriage and second marriage
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The high cost of living
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The increased number of women in this older reproductive age group
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The increased availability of specialized fertilization procedures
Learning Objective 9
Compare similarities and differences in the needs of expectant women in various age groups.
Concepts for Lecture
1 Advantages of Older Mothers
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Tend to be well educated and financially secure
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More aware of the realities of having a child
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Feel secure about taking on the added responsibility of a child
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May be ready to stay home with a new baby
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Can afford good child care
2. Risks for Older Mothers
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More likely to have chronic medical conditions
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Increased incidence of low-birth-weight and preterm infants
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Increased rate of miscarriage
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Increased risk for cesarean delivery
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Increased risk for infant with Down syndrome
3. Risks for Older Mothers
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Increased risk for
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Gestational diabetes mellitus
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Hypertension
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Placenta previa
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Difficult labor
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Newborn complications