Nursing Care During Pregnancy
All RHUs and BHS should have a masterlist of pregnant women in their respective catchment areas. Barangay Health Workers (BHW). Traditional Birth Attendants (TBAs) or hilots and other community members concerned with maternal health or community health should be encouraged to help identify pregnant women in the community and motivate them to submit to prenatal care.
The Home Based Mother’s Record (HBMR) shall be used when rendering prenatal care as a guide in the identification of risk factors, danger signs, and to be able to do appropriate measures. Health promotion messages and information on danger signs must be given emphasis.
In areas where licensed health personnel are not available, a BHW or TBA shall be trained to do regular prenatal visits using the Home Based Mother’s Record (HBMR) to identify risks/danger signs, and to make correct referral to health facilities.
There should be at least 3 prenatal visits during pregnancy following the prescribed timing:
- The first prenatal visit should be made as early in pregnancy as possible, during the first trimester.
- Second visit during the second trimester.
- The third and subsequent visits during the third trimester.
- More frequent visits should be done for those at risk/with complications.
The standard prenatal physical examination per visit shall include the following: weight, height and blood pressure taking, examination of the eyes (conjunctiva) and palms of the hand for pallor, abdominal examination to include fundic height, fetal position, presentation and fetal heart tones when applicable; face, hands and lower extremities for edema, examination of the breast, and examination of the neck for thyroid gland enlargement (goiter).
The basic prenatal service delivery at the hospitals, RHU and BHS should include the following: history taking, physical examination, treatment of disease, tetanus toxoid immunization, iron supplementation, health education, laboratory examination and oral dental examination (except in BHS) and proper referral to the next higher level when applicable.
In addition, at the hospital where specific laboratory and radiologic examinations may be available these should be done when needed.
All pregnant women shall be given Tetanus Toxoid Immunization according to the WHO recommended schedule.
Iron supplementation shall be given from the 5th month of pregnancy up to 2 months postpartum. (100 – 200 mg. orally per day daily per orem for 210 days)
In goiter endemic areas, all pregnant women shall be given one iodized oil capsule every year.
In malaria infested areas, all pregnant women shall be given prophylaxis in the form of Chloroquine (150 mg. base/tablet) 2 tablets per week for the whole duration of pregnancy.
Source: Community Health Nursing Services in the Philippines
December 15th, 2008 | Tags: nursing care, Pregnancy, prenatal | Category: Pregnancy
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