Childbearing: Pregnancy By Trimester

• Alterations affecting comfort, rest, mobility - musculoskeletal system
1. Physiological changes
1. Progesterone, estrogen, and relaxin-induced relaxation of joints, cartilage, and ligaments.
2. Function in childbearing - increases anteroposterior diameter of rib cage and enlarges birth canal.
2. Assessment:
1. Complaint of pelvic “looseness.”
2. Duck-waddle walk.
3. Tenderness of symphysis pubis.
4. Lordosis (exaggerated lumbar curve) - increased weight of pelvis tilts pelvis forward; to compensate, woman throws head and shoulders backward; complaint of leg and back strain and fatigue.
3. Nursing care plan/implementation:
Goal: health teaching
1. Good body alignment - tuck pelvis under; tighten abdominal muscles.
2. Pelvic-rock exercises.
3. Squat; bend at knees, not at waist.
4. Wear low-heeled, sturdy shoes.
5. Avoid tight-fitting clothing that interferes with circulatory return in legs.