| Assessment/Characteristics | Nursing Care Plan/Implementation |
|---|
| First Trimester |
| Emotional lability (mood swings) | Encourage verbalization of feelings, concerns |
| Displeasure with subjective symptoms of early pregnancy (nausea, fatigue, etc.) | Health teaching: diet, rest, relaxation, diversion |
| Feelings of ambivalence | Validate normalcy of feelings, behaviors |
| Second Trimester |
| Accepts pregnancy (usually coincides with awareness of fetal movement [i.e., “quickening”]) | Encourage exploration of feelings of dependency, introspection, mood swings |
| Becomes introspective: resolves old conflicts (feelings toward mother, sexual intimacy, masturbation) | Discuss childbirth preparation and preparation-for-parenthood classes; refer, as necessary |
| Reevaluates self, lifestyle, marriage |
| Daydreams, fantasizes self as “mother” |
| Seeks out other women who are pregnant and new mothers |
| Third Trimester |
| Altered body image | Encourage verbalization of concerns, discomforts of late pregnancy |
| Fears body mutilation (stretching of body tissues, episiotomy, cesarean birth) | Help meet dependency needs; offer reassurance, as possible |
| Distress over loss of control over body functions (ptyalism, colostrum leakage, leukorrhea, urinary frequency, constipation, stress incontinence) | Health teaching: Kegel exercises; preparation for labor. Anticipatory guidance and planning for needs of self, baby, and family in early postpartum |
| Anxiety for baby (deformity, death) |
| Fears pain, loss of control in labor |
| Acceptance of impending labor during last 2 weeks (ready to “move on”) |