First Trimester - FirstTrimester NURSINGPRIORITIES

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First Trimester NURSING PRIORITIES 1. Encourage client to adopt health-promoting behaviors. 2. Detect actual or potential risk factors. 3. Prevent/treat complications. 4. Foster client’s/couple’s positive adaptation to pregnancy. NURSING DIAGNOSIS: Nutrition: altered, risk for less than body requirements Risk Factors May Include: Changes in appetite, presence of nausea/vomiting, insufficient  finances, unfamiliarity with increasing metabolic/nutritional needs Possibly Evidenced By: [Not applicable; presence of signs/symptoms establishes an  actual  diagnosis] DESIRED OUTCOMES/EVALUATION  Explain the components of a well-balanced  CRITERIA—CLIENT WILL: prenatal diet, giving food sources of vitamins, minerals, protein, and  iron. Follow recommended diet. Take iron/vitamin supplement as prescribed. Demonstrate individually appropriate weight gain (usually a  minimum of 3 lb by the end of the first trimester). ACTIONS/INTERVENTIONS RATIONALE Independent Determine adequacy of past/present nutritional  Fetal/maternal well-being depends on maternal  habits using 24-hr recall. Note condition of hair,  nutrition during pregnancy as well as during the 2  nails, and skin. yr preceding pregnancy. Obtain health history; note age (especially less  Adolescents may be prone to malnutrition, eating  than 17 yr, more than 35 yr). disorders, anemia; and older clients may be prone to  obesity/gestational diabetes. (Refer to CPs: The  Pregnant Adolescent; Diabetes Mellitus:  Prepregnancy/Gestational.)
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Ascertain knowledge level of dietary needs. Determines specific learning needs. In the prenatal  period, the basal metabolic rate (BMR) increases by  20%–25% (especially in late pregnancy), owing to  increased thyroid activity associated with the  growth of fetal and maternal tissues, creating a  potential risk for the client with poor nutrition.  An additional 800 mg of iron is necessary during  pregnancy for developing maternal/fetal tissue  and fetal storage. During the first trimester, the  demand for iron is minimal, and a balanced diet  meeting increased caloric needs is usually  adequate. (Note: Iron preparations are not commonly  prescribed in the first trimester because they may  potentiate nausea.) Folic acid is crucial to fetal   development requiring daily supplement of  0.4 mg of folate to prevent maternal deficiencies. Provide appropriate oral/written information  Reference material can be reviewed at home,  about prenatal diet, food choices, and daily  increasing the likelihood that the client will select a  vitamin/iron supplements. well-balanced diet.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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First Trimester - FirstTrimester NURSINGPRIORITIES

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