MINOR AILMENT DURING

PREGNANCY

HEARTBURNS AND
NURSING MANAGEMENT
NUR 3112: OBSTETRIC
NURSING
GROUP 6

NO

NAME

MATRIC NO

RAZILA BINTI RAMLI

1319896

NUR ARINA BINTI ABD GHANI

1314534
1311706

NORHASYIMAH BT GHAZALI

SITI NUR YASMIN BINTI NORDIN

1314040

NURULHUSNAA BINTI AWANG KECHIK

1315952

INTRODUCTION
Heartburn is a symptom created by acid reflux, which results in the
diagnosis of gastroesophageal reflux disease (GERD) if it persists and
happens more than twice a week. It is a very common symptom
described by an internal burning pain felt around the lower chest area.

OBJECTIVES
1. To know the definition of heartburn
2. To determine the etiology of heartburn and pathophysiology
of the heartburn
3. To understand the sign and symptoms related to heartburn
and the complications
4. To explain the management of the heartburn in pregnancy
5. To evaluate the nursing diagnosis and plan for nursing
interventions and medical management
6. To give health education to the mother for self management
prior the heartburn

DEFINITION
Heartburn is felt when stomach acid
flows back up into the food pipe - the
gullet, down which food moves from the
mouth to the stomach.
(following the GERD)

ETIOLOGY
Eating spicy food
Consuming caffeine
Alcohol
Smoking
Lying down immediately after eating
Eating fatty food

PATHOPHYSIOLOGY
Uterus rises out of the pelvic(getting bigger)

Decrease lower esophageal sphincter pressure

Decrease normal pressure gradient between the stomach and
esophagus(pressure from stomach below increase over the
pressure from above stomach)
Promoting reflux of gastric contents(acid and food pushed back up
towards esophagus
Unpleasant burning sensation

SIGN & SYMPTOMS

Pain that worsens when lying down
or bending over

Burning pain in the chest usually

after eating.

COMPLICATIONS
Esophageal Bleeding and Ulcers
Inflammation of Esophagus
(Esophagitis)
Esophageal Cancer

DIAGNOSTIC TEST
Avoid barium radiographs
Upper gastrointestinal (GI) endoscopy
-examine esophagus for esophagitis
Manometry
- identifies problems with motility and valve
pressure in the esophagus

MANAGEMENT
MANAGEMENT
1.
1. LIFESTYLE
LIFESTYLE AND
AND DIET
DIET
2.
2. MEDICATION
MEDICATION

1. LIFESTYLE AND DIET

Eating too much food
Eating small portions
Avoid eating fatty food& acidic food
High-fat foods take longer to digest in the stomach
Ex: tomatoes, citrus fruit
Avoid drinks that may trigger heartburn ex:
caffeine(boost acid in stomach)
carbonated drinks can bloat stomach which increases the risk for heartburn
Try chewing gum
Chewing gum produces saliva and saliva neutralizes acid and signals the stomach to move its
contents into the small intestine
Stay sitting upright position after eating as lying down may cause you to regurgitate your food

Dont smoke- smoking can increase acid

2. MEDICATION
Antacids -neutralize stomach acids
Histamine-2 receptor antagonists -Ranitidine
-decrease the amount of acid that the stomach,
which may reduce irritation to the stomach lining
Proton pump inhibitors (PPIs) -Omeprazolereduce stomach acid

NURSING CARE PLAN

1) NURSING
DIAGNOSIS
Acute pain
related to
heartburn
remain at the
lower chest as
evidence by
patient
complaint

GOAL
Patient will
feel free from
the pain

INTERVENTION
1) Assess pain
score of the
patient
2) Keep patient rest
in semi-Fowlers
position
3) Advice patient to
avoid heavy
meal
4) Teach patient to
do relaxation
technique
5) Instruct patient
to take
medication as
prescribe by

RATIONAL

EVALUATION

1)To monitor the Patient feel free

healing
from pain
progression
2) To reduce
pain fro worse
3) To decrease
the heartburn at
the lower chest
4) Relation can
make patient
feel relax
5)To control pain
and reduce
discomfort

2) NURSING
DIAGNOSIS

GOAL

INTERVENTION

Impaired comfort Patient will relax 1) Assess the level of

related to
and feel comfort
comfort for the
irritation at the
patient
stomach as
2) Teach patient
evidence by
breath technique
patient
3) Ask patient to
expression
chewing gum after
eating
4) Ask patient to
avoid drinking
large quantities of
fluid during meals
5) Advice patient to
wear loose,
comfortable
clothing

RATIONAL

EVALUATION

1) To create the
Patient feel
situation that
comfort
patient
comfortable
2) Breathing
properly can
reduce the pain
3) Chewing gum
can stimulate
the salivary
gland to
neutralize acid
4) Avoid distend
the stomach
5) To avoid any
tightness
around the
waist and
tummy

3) NURSING
DIAGNOSIS
Knowledge
deficit related
misunderstood
as evidence by
inaccurate
perceptions of
health status

GOAL

INTERVENTION

RATIONAL

EVALUATION

Patient will
understand
disease
process, causes
and factors
contributing to
symptoms

1) Assess clients
understanding,
ability to the
knowledge given.
2) Provide
information to
support self
management
toward her
condition
3) Show the
demonstration
about the
information given.
4) Use visual aid of
the instruction
given
5) Evaluate learning
outcomes using
patient
verbalization.

1) To know the
level of her
understanding
2) To make sure
patient get the
knowledge
3) Patient will get
the effective
information.
4) Patient will
remember
what
information
given.
5) The
effectiveness
of the
information
given can be
assessed.

Patient
understand and
can recognize the
symptoms.

HEALTH EDUCATION
Eat several small meals each day
Mother must eat slowly
Avoid fried, spicy or rich foods
Dont lie down immediately after eating
Keep the head of the bed higher than foot during
lying down to prevent stomach acid rise to the
chest
The medication as prescribe by doctor

CONCLUSIONS
Whenever a Muslim is afflicted by harm from
sickness or other matters, God will expiate his sins,
like leaves drop from a tree.
(Bukhari and Muslim)
Sometimes the good health or good time can be
followed by sickness or injury and sadness. This is a
part of test to lessen the sins for a true believer.

REFERENCES
Balentine, J. R., & Anand, B. ( 2014, February 12). Why Does The Acid Back Up Into The Esophagus?
Retrieved from http://
www.emedicinehealth.com/heartburn_faqs/page2_em.htm#why_does_the_acid_back_u
p_into_the_esophagus
Balentine, J. R., & Anand, B. ( 2014, February 12). What Kinds of Complications are Caused by
Frequent Heartburn? Retrieved from http://www.emedicinehealth.com/heartburn_faqs/page8_em.htm
Burke, D., & Krucik, G. ( 2012, July 18). What Causes Heartburn? 21 Possible Condition.
from http://www.healthline.com/symptom/heartburn

Retrieved

Susan,B. (2014). Maternal, Fetal, & Neonatal Physiology. Printed in United States of
America published by Elsevier Saunders.

THANK YOU