NCLEX Review Guide: Discomforts of Pregnancy

Nausea and Vomiting (Morning Sickness)

• Occurs in 70-80% of pregnancies due to rising hCG and estrogen levels, typically peaks at 8-12 weeks gestation.
• Recommend small, frequent meals, dry crackers before rising, and avoiding triggers like strong odors or spicy foods.

Breast Tenderness

• Caused by increased estrogen and progesterone levels, begins as early as 2 weeks after conception.
• Advise wearing a well-fitting, supportive bra and avoiding caffeine which can increase sensitivity.

Urinary Frequency

• Results from increased blood volume and pressure from enlarging uterus on bladder in early pregnancy.
• Rule out UTI if accompanied by burning, urgency, or fever - always assess for infection signs.

Heartburn and Indigestion

• Caused by progesterone-induced relaxation of cardiac sphincter and upward pressure from growing uterus.
• Recommend small, frequent meals, avoiding spicy/fatty foods, and remaining upright after eating for 1-2 hours.

Constipation

• Results from progesterone slowing intestinal motility and iron supplements reducing gut movement.
• Encourage increased fiber intake (25-35g daily), adequate fluid intake (8-10 glasses water), and regular exercise.

Back Pain

• Occurs due to relaxin hormone softening ligaments and altered center of gravity from growing uterus.
• Recommend proper body mechanics, low-heeled shoes, prenatal yoga, and sleeping with pillow support.

Leg Cramps

• Common in third trimester, possibly related to calcium/magnesium imbalance or pressure on nerves.
• Immediate relief: dorsiflex foot and massage calf muscle - teach this technique to all pregnant clients.