Oedema in pregancy

Why it happened ?
Swollen ankles and feet (oedema) happen in pregnancy because of
body is holding on to more fluid than usual.
As the baby grows, the uterus (womb) puts pressure on the blood
vessels in pelvis. This particularly affects the large vein (inferior
vena cava) on your right-hand side which receives blood from lower
limbs.
This pressure slows blood circulation in the area and causes the
blood to pool.
Pressure from this trapped blood forces water down and out
through tiny vessels (capillaries), and into the tissues of the feet
and ankles.
This water is normally absorbed by body, but because of
pregnancy, body retain more water, which adds to the swelling.

Swelling tends to get progressively

worse as the day goes on, and is
better in the morning, after you've
been lying in bed. Later in the day, if
you press the skin around your ankles,
the skin may not spring back straight
away.
Towards theend of your pregnancy,
the swelling may affect your hands. If
you're wearing rings, they may feel
tight on your fingers.

Complications

Increasingly painful swelling

Difficulty walking
Stiffness
Stretched skin, which can become itchy and
uncomfortable
Increased risk of infection in the swollen area
Scarring between layers of tissue
Decreased blood circulation
Decreased elasticity of arteries, veins, joints and
muscles
Increased risk of skin ulcers

Prevention
Put the feet up whenever possible, as this will help with circulation.
Atwork, keep a footstool or box under desk. At home, try to lie down
on left side, as this takes pressure off the inferior vena cava.
Try not to stand for long periods of time. At work, should be able to
take regular breaks. Put support tights on before get out of bed in the
morning, so blood has no chance to pool around your ankles.
Wear compression stockings.
Exercise regularly, especiallywalking, swimming. If travelling long
distances, take regular breaks to stretch the legs.
If skin isn't too tight and painful, ask someone to massage ankles and
feet, using upward strokes towards the knees. This can help to move
the fluid away from the feet.

Nursing management

Nursing
diagnosis

Nursin
g goal

Nursing interventions

Excessive
fluid
volume
related to
increase
fluid
retention
as
evidence
by the
presence
of oedema
in the
extrimities

To
reduce
the
oedem
a

Monitor the input and ouput

Patient
chart of the patient
oedema was
Monitor the blood pressure
decrease as
of the patient to be in normal
evidence by
within normal range 120/80
pitting
Elevate oedematous
oedema
extremities.
(1-2 seconds)
Change in position
Patient have
frequently to avoid pooling
balance input
of fluid in extremities
and output
Educate patient about
restriction of sodium in diet
intake

12/25/16

Evaluations

Nursing
diagnosis

Nursin
g goal

Disturb
body
image
related to
fluid
retention
at the
extremities
as
evidence
by swelling
at the
extremities

Patient Observe emotional changes

have
of the patient.
positive Establish therapeutic nurse
mind
-client relationship
of self
Assessed client current level
of adaptation and progress
Encourage patient to asked
about the problem they have
Encourage family member to
give moral support to the
patient

12/25/16

Nursing interventions

Evaluations
Patient
understand
about the cause
of changes of
body image by
verbalised the
problem.

10

conclusion