PHYSIOLOGIC ADAPTATION TO PREGNANCY
Systemic Changes 1. Cardiovascular System
- blood volume 30 – 50%
- 1500 cc; additional 500 cc for multiple pregnancy
- plasma volume
- cardiac workload – easy fatigability/ slight ventricular hypertrophy
- Epistaxis due to hyperemia of nasal membrane
- Palpitation due to SNS stimulation
- Physiologic Anemia/ pseudoanemia in pregnacy
- o Normal Value
- Hct : 32 – 42%
- Hgb: 10.5 – 14 g/dl
- o Criteria
- 1st & 3rd Trimester : Hct > 33% Hgb > 11 g/dl
- 2nd Trimester : Hct > 32% Hgb > 10.5 g/dl
- o Pathologic Anemia
- # Iron Deficiency Anemia is the most common hematologic disorder. It affects
- 20% of pregnant women
- # Assessment reveals:
- -Pallor
- -Slowed capillary refill = Normal = 2 – 3 sec
- -Concave fingernails (late sign of progressive anemia) – clubbing = chronic
- tissue hypoxia
- -Constipation
- # Nursing care
- -Nutritional instruction
- o Source of iron
- Kangkong
- Liver = best source due to FERRITIN Content
- Red and lean meat
- Green Leafy Vegetables
- - Parenteral Iron (Imferon)
- o Z tract IM
- o incorrect causes hematoma
- o best given 1 hour before meals (causes GI irritation)
- o Maybe given 2 hours after meal (results to poor absorption)
- * Given with orange juice to absorption
- - Oral Iron Supplements (ferrous sulfate 0.3 g 3 x a day)
- - Monitor for hemorrhage
- # Alert
- - Iron from red meat is better absorbed iron from other sources
- -Iron is better absorbed when taken with foods high in Vitamin c such as
- orange juice
- - Higher iron intake is recommended since circulating blood volume is
- increased and heme is required from production of RBC's.