N1 · Pregnancy discomfort
Actual Maternal and newborn
Definition
Physical discomfort during pregnancy such as backache, nausea, or swelling.- Hormones
- growing uterus
- weight gain
- fatigue
- Backache
- nausea
- swelling
- heartburn
- sleep trouble
📋 Scenario
A woman at 30 weeks has backache and heartburn.
Subjective (S): "My back aches and I get heartburn."
Objective (O): 30 weeks pregnant; backache 5/10; heartburn after meals; ankle swelling; vital signs normal.
Assessment tools for this scenario: CP-MOTHER Mother & Newborn Check CP-PAIN Pain & Comfort Score
Validated scales to consider: MEOWS, APGAR, NRS 0–10, FLACC, PAINAD
**CarePath diagnosis:** Pregnancy discomfort related to hormonal and physical changes of pregnancy, as evidenced by backache 5/10, heartburn after meals, and ankle swelling.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Reassure. | Reassurance that these common changes are expected in pregnancy lowers worry, and anxiety can make discomfort feel worse. |
| Teach comfortable positions. | Good posture and positions, such as side-lying with pillows, reduce strain on the back and take pressure off the growing uterus. |
| Suggest small meals. | Small meals leave less food in the stomach at a time, which reduces pressure and acid reflux that cause heartburn. |
| Encourage rest. | Rest eases muscle fatigue and strain in the back and legs, and helps the body cope with the extra workload of late pregnancy. |
| Allow warm baths if permitted. | Warm baths can relax tight muscles, but they are only used if permitted because heat is not safe in every pregnancy. |
| Teach warning signs to report. | Knowing warning signs lets her tell normal discomfort from problems such as severe headache or bleeding, so she seeks help early when needed. |
**Expected outcomes**
- Within 1 week: reports discomfort 3/10 or lower, uses 2 comfort methods, knows warning signs.
**Linking the data to the diagnosis**
At 30 weeks, the woman says, "My back aches and I get heartburn." She has backache 5/10, heartburn after meals and ankle swelling, and her vital signs are normal. This fits pregnancy discomfort because the symptoms are common, caused by hormones and the growing uterus, and no danger signs are present, which separates it from the high-risk pregnancy statement. The problem is already present, so it is actual. The plan aims for her, within 1 week, to report discomfort at 3/10 or lower, use 2 comfort methods and know the warning signs to report.
CarePath diagnosis
Pregnancy discomfort related to hormonal and physical changes of pregnancy, as evidenced by backache 5/10, heartburn after meals, and ankle swelling.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Reassure. | Reassurance that these common changes are expected in pregnancy lowers worry, and anxiety can make discomfort feel worse. |
| 2. Teach comfortable positions. | Good posture and positions, such as side-lying with pillows, reduce strain on the back and take pressure off the growing uterus. |
| 3. Suggest small meals. | Small meals leave less food in the stomach at a time, which reduces pressure and acid reflux that cause heartburn. |
| 4. Encourage rest. | Rest eases muscle fatigue and strain in the back and legs, and helps the body cope with the extra workload of late pregnancy. |
| 5. Allow warm baths if permitted. | Warm baths can relax tight muscles, but they are only used if permitted because heat is not safe in every pregnancy. |
| 6. Teach warning signs to report. | Knowing warning signs lets her tell normal discomfort from problems such as severe headache or bleeding, so she seeks help early when needed. |
Expected outcomes
- Within 1 week: reports discomfort 3/10 or lower, uses 2 comfort methods, knows warning signs.
Linking the data to the diagnosis
At 30 weeks, the woman says, "My back aches and I get heartburn." She has backache 5/10, heartburn after meals and ankle swelling, and her vital signs are normal. This fits pregnancy discomfort because the symptoms are common, caused by hormones and the growing uterus, and no danger signs are present, which separates it from the high-risk pregnancy statement. The problem is already present, so it is actual. The plan aims for her, within 1 week, to report discomfort at 3/10 or lower, use 2 comfort methods and know the warning signs to report.