孕晚期健康教育

孕晚期健康教育 产科健康教育内容 孕晚期健康教育 一、晚孕期的定义: 从妊娠28周至40周期间，称为晚期妊娠，37周以后分娩，称足月产。 二、生理变化 1、胎儿深居子宫之中，生活在恒温、无菌、少震安全环境中，受羊水及母体保护。 2、乳房变的十分丰满，可以挤出初乳，在接近预产期2—3周可以轻微乳房按摩，为哺育婴儿做好最好的准备。 3、胎动十分明显，尤其在下午及晚餐后，近预产期胎动相对减弱。 4、下肢可能肿胀，但休息后应减轻或消失。 三、妊娠期的健康指导 1、定期产前检查非常重要，一般28—36周每2周一次，36—40周每周一次或遵医嘱，40周后应遵医嘱住院监护，避免因胎盘功能衰退导致胎儿宫内缺氧，窘迫甚至猝死，此期应遵医嘱行胎监、胎儿脐血流及B超等相关检查。 2、注意胎动监护，每早、中、晚监测一小时，每小时3次以上为正常，过频或过少均提示胎儿可能异常，应及时就诊，自数胎动是最方便实际的自我监护。 3、远程家庭胎儿监护系统是安装在医院的胎儿监护仪，远程监护信息系统和孕妇使用的远程胎儿多普勒探测仪组成，孕妇可在家里做自我监护，随时接受专业医生的指导，实现“天天监护、按需监护”的目的，确保安全度过孕期。高危孕妇在32周、不高危孕妇在36周开始监护。 4、保持外阴清洁，妊娠时由于阴道分泌物增加，容易发生泌尿系感染，应注意保持外阴清洁勤换内裤，宜穿透气性、吸水性好的棉质内裤。外阴以weather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to the project demand organization ahead in rainy season construction materials used and the entry of machinery and spare parts, for the smooth start of the rainy season to provide physical protection. (6) do lightning protection lightning protection, and conduct a comprehensive inspection to ensure mine safety. High temperature construction measures for Zhuhai area in summer high temperatures, the characteristics of long duration, high temperatures in the summer season, the construction process, to ensure the safety and health of workers, ensuring smooth construction, focus on work safety, cooling, and disease prevention. 8.3.2.1 preparations during the summer season construction site management and staff management responsibility to the people, careful supervision, responsibility to the people, and effective measures, ensure employee health and the smooth progress of the project. 8.3.2.2 concrete measures (1) during the summer season, put an end to common disease epidemic. In increasing nutrition to workforce (especially a first line of production and post staff) provide cool summer drugs such as mung bean soup, to ensure safety and health. In special circumstances (such as open, closed 清水淋洗即可，便后使用清洁卫生纸，并从前向后擦拭。 5、乳头如有平坦或凹陷，应在此期进行纠正，将两指在乳头两侧慢慢地由乳头向两外侧拉出，牵拉乳晕的皮肤及皮下组织，使乳头向外突出，每日两次，每次5分钟，此动作在妊娠37周以后进行，避免引起早产。 6、妊娠7个月后不宜参加夜班工作，保证每天有充足的睡眠(8-10小时)，中午应有1-2小时的休息，宜取左侧卧位，以保证子宫胎盘的血灌注，减轻下肢水肿，避免疲劳。 7、孕36周后，要注意阴道流血(临产先兆)，阴道流水(早破水)、规律腹痛、如10分钟内痛1-2次(临产)，要及时来住院就诊，经产妇一有宫缩就应立即前来就诊。 8、保证足够的营养，增加纤维素食品及蔬菜、水果的摄入，养成每天排便的习惯，防止便秘。 9、性生活指导:妊娠12周以内及32周以后应该避免性生活，以免因兴奋和机械性刺激引起盆腔充血，子宫收缩而造成流产、早破水或早产，并避免细菌带入阴道而导致产前、产时、产后的感染。 临产时的健康教育 临产先兆: 1、腹痛持续时间短但不，常在夜间出现而于清晨消失。 2、有胎儿下降感，即感到上腹部较前舒适，进食量增多，有尿频感，系因先露下降进入骨盆。 3、见红，因宫颈内口附近的胎膜与该处子宫壁分离所致，这是分娩将开始的一个可靠征象。 4、破水:不能自我控制的阴道流水。 正式临产: 1、规则宫缩，宫缩时，腹部隆起变硬感觉疼痛，间歇时腹部变软(疼痛缓解)，约5-6分钟一次。 closed staff) provide cool summer drugs such as mung bean soup, to ensure safety and health. In special circumstances (such as open,post eason, put an end to common disease epidemic. In increasing nutrition to workforce (especially a first line of production andve measures, ensure employee health and the smooth progress of the project. 8.3.2.2 concrete measures (1) during the summer sffectin site management and staff management responsibility to the people, careful supervision, responsibility to the people, and eonstruction, focus on work safety, cooling, and disease prevention. 8.3.2.1 preparations during the summer season constructioooth con, high temperatures in the summer season, the construction process, to ensure the safety and health of workers, ensuring smafety. High temperature construction measures for Zhuhai area in summer high temperatures, the characteristics of long duratimine svide physical protection. (6) do lightning protection lightning protection, and conduct a comprehensive inspection to ensure eason construction materials used and the entry of machinery and spare parts, for the smooth start of the rainy season to proemand organization ahead in rainy sweather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to the project d2 2、宫口扩张及胎头下降，这些可通过肛门直肠检查了解。 3、胎膜多在临产后自然破裂。 临产后注意: 1、在宫缩间歇时少量多次进食，吃高热量易消化食物，并摄入足够水分，以保证精力和体力充沛。 2、若宫缩不强，未破水，可作适当运动，有助产程进展。 3、应每2-3小时排便一次，以免膀胱胀影响宫缩、胎头下降。 4、采取以下几种方法可减轻疼痛:1、腹式深吸:随意体位，全身放松，在宫缩即将开始前，自然的将气吸入下腹，然后充分呼吸，每分钟11-13次。2、按摩:两手五指合拢，轻放在下腹部，拇指与脐平，宫缩时边吸气边在腹部滑动，边呼吸边将两手滑回原处。 5、宫口开3cm护士将产妇送至待产室继续观察。 产褥期健康教育 一、定义: 胎儿及附属物排出至全身器官恢复到妊娠前状态(乳房除外)，约6-8周，称产褥期。 二、注意阴道出血情况，出血量多，持续或偶有头晕心慌等，应及时汇报，哺乳时按摩子宫，可促进子宫收缩，帮助恶露排出。 三、预防产后尿潴留 产后2-4小时及时饮水和排尿。可避免尿潴留和导尿所致的泌尿系统感染的发生。 四、产后卧床休息，6小时后可坐起，体力恢复好者，在家人或护理人员的陪同下早期下床活动;可促进食欲，保持小便通畅，有利于机体恢复。禁止从事重体力劳动，以防止子宫脱垂。 五、每天保证有8-10小时的休息，学会和婴儿同步休息，心情要轻松愉快，避免产后抑郁症。 health. In special circumstances (such as open, closed (especially a first line of production and post staff) provide cool summer drugs such as mung bean soup, to ensure safety andforce .3.2.2 concrete measures (1) during the summer season, put an end to common disease epidemic. In increasing nutrition to workision, responsibility to the people, and effective measures, ensure employee health and the smooth progress of the project. 8uperveparations during the summer season construction site management and staff management responsibility to the people, careful ssafety and health of workers, ensuring smooth construction, focus on work safety, cooling, and disease prevention. 8.3.2.1 pr re thetemperatures, the characteristics of long duration, high temperatures in the summer season, the construction process, to ensuduct a comprehensive inspection to ensure mine safety. High temperature construction measures for Zhuhai area in summer high d confor the smooth start of the rainy season to provide physical protection. (6) do lightning protection lightning protection, an the project demand organization ahead in rainy season construction materials used and the entry of machinery and spare parts,weather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to 3 六、产后饮食搭配宜适当，产后第一天可吃清淡，易于消化的食物，以后饮食为富有营养及足够热量为原则，除肉、鱼、蛋、鸡外，还需多吃蔬菜和水果，多喝汤类及奶类，促进身体的恢复和乳汁的分泌，常用的催乳汤类及食物是猪脚花生汤、鱼头豆腐汤、,豆猪骨汤、清炖鲜鲫鱼汤、,水豆煎或煮粥。 七、注意乳房的保护，按需哺乳，哺乳前清洁乳头，哺乳后挤一点乳汁涂拭乳头，预防乳头皲裂和乳腺炎的发生。 八、分娩后应注意皮肤及外阴的清洁，在阴道流血停止前，使用消毒卫生巾，多汗时要勤换衣物，保持空气流通，注意保暖。防止感冒，产后2个月禁盆浴及性生活，产后42天回院行产科检查，了解子宫复旧，伤口愈合，乳房和母乳喂养的情况。 九、坚持做产后保健操，如仰卧抬腿运动，仰卧起坐和缩肛运动等，每日二次，每天15分钟，可加速恢复健美的体形。 十、性生活指导:性生活时间和避孕套。 十一、剖宫产的产后护理:1、多翻身、鼓励病人尽早下床活动，可促进肠蠕动恢复及恶露排除;2、术后当天禁食，6小时后改流质，如正常排气，第二天可进半流质，第三天可正常进食;3、注意阴道流血及排尿情况，术后5—7天左右拆线。 十二、科学合理护理新生儿 1、坚持母乳喂养，早吸吮，按需哺乳。 2、如何判断母乳是否充足:母亲:哺乳前母亲的乳房胀满,婴儿吸吮乳房后松软、舒适。婴儿吸奶力大，吸奶时有连续吞咽奶声，吸奶后安静，可连续睡眠2—3小时，体重增加，小便4—6次/日，大便3—5次/日。 3、脐带的护理:脐部创面未干燥前，每次沐浴后用75%酒精消毒脐部，并查看脐部有无液体渗出，有无异味，脐轮周围有无潮红或出血，要勤换尿布，以免发生脐炎。 closed staff) provide cool summer drugs such as mung bean soup, to ensure safety and health. In special circumstances (such as open,post eason, put an end to common disease epidemic. In increasing nutrition to workforce (especially a first line of production andve measures, ensure employee health and the smooth progress of the project. 8.3.2.2 concrete measures (1) during the summer sffectin site management and staff management responsibility to the people, careful supervision, responsibility to the people, and eonstruction, focus on work safety, cooling, and disease prevention. 8.3.2.1 preparations during the summer season constructioooth con, high temperatures in the summer season, the construction process, to ensure the safety and health of workers, ensuring smafety. High temperature construction measures for Zhuhai area in summer high temperatures, the characteristics of long duratimine svide physical protection. (6) do lightning protection lightning protection, and conduct a comprehensive inspection to ensure eason construction materials used and the entry of machinery and spare parts, for the smooth start of the rainy season to proemand organization ahead in rainy sweather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to the project d4 4、皮肤的护理:每天洗澡一次，勤换尿布，大便后用温水或湿纸巾擦拭臀部并注意保暖。 5、注意新生儿皮肤颜色的变化，尤其注意哺乳前后的颜色，口周皮肤颜色的变化，如有青紫色立即就诊。 6、新生儿二便的观察:头几天为黑便(胎便)，吃母乳后转为黄色或青色。 7、按时进行儿童保健及预防接种。 8、新生儿异常情况的观察，如新生儿黄疸加深，尿布性皮炎，脓疱疮、脐炎或脐出血时，应立即就诊。 母乳喂养宣教 好处:1、营养(是婴儿最好的食品);2、防病(有抗体、增强婴儿抵抗力);3、增进母婴感情;4、有利于产妇健康(促进子宫收缩)。 早接触、早吸吮:阴道分娩的婴儿在产后30分钟内即与母亲皮肤接触，并早吸吮半小时，剖宫产在手术室产妇与婴儿脸贴脸亲10分钟，待产妇回病房后即行皮肤接触并早吸吮产半小时。 母婴同室:母亲与婴儿24小时在一起，每天分开不超过1小时。 哺乳正确体位、姿势:母亲放松舒适，婴儿身体贴近母亲，脸向乳房，鼻尖对乳头，下颌对乳房，头与身体呈一直线，母亲应托着婴儿的臀部。 母亲正确托乳房姿势:把食指至小指并拢放在乳房下的胸壁上，用食指托住乳房底部，拇指轻轻放在乳房上方，手不应离乳头太近。 婴儿正确的含接姿势(吸吮):婴儿嘴张大，将乳头及大部分乳晕吸入嘴内，含接时可见到上方的乳晕比下方多，面颊鼓起，有慢而深的吸吮，并听到有节奏的吞咽声。 何时喂奶:喂奶次数和时间都无限制，按需哺乳:即婴儿啼哭饥饿时便喂，母亲乳胀时便喂。 health. In special circumstances (such as open, closed (especially a first line of production and post staff) provide cool summer drugs such as mung bean soup, to ensure safety andforce .3.2.2 concrete measures (1) during the summer season, put an end to common disease epidemic. In increasing nutrition to workision, responsibility to the people, and effective measures, ensure employee health and the smooth progress of the project. 8uperveparations during the summer season construction site management and staff management responsibility to the people, careful ssafety and health of workers, ensuring smooth construction, focus on work safety, cooling, and disease prevention. 8.3.2.1 pr re thetemperatures, the characteristics of long duration, high temperatures in the summer season, the construction process, to ensuduct a comprehensive inspection to ensure mine safety. High temperature construction measures for Zhuhai area in summer high d confor the smooth start of the rainy season to provide physical protection. (6) do lightning protection lightning protection, an the project demand organization ahead in rainy season construction materials used and the entry of machinery and spare parts,weather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to 5 早产的健康教育 早产是指妊娠满28-37周之间终止者，此时娩出的新生儿体重低，发育尚不成熟，因此，未满37周而有腹痛，阴道流水应立即到医院安胎治疗。 1、卧床休息，避免精神紧张。2、如腹痛同时阴道流水，应抬高臀部，避免脐带脱出而危及胎儿生命。3、一些药物可促使胎儿生长成熟;增加胎儿成活率，请勿担扰。4、在输入某些药物的同时会使用一些监测仪器，这样会限制了您的活动，请配合。5、左侧卧位，定时吸氧，都可增加母体血氧浓度，使供给胎儿的氧气及营养也相应增加。6、勿刺激乳头及用腹压。以免引起宫缩。7、进食高纤维，高维生素食物，多饮水防防便秘。 过期妊娠的健康教育 凡月经规则的妇女妊娠超过42周者为过期妊娠，如果妊娠即将过期，请注意以下事项: 自数胎动:每天的胎动次数是自我监测胎儿安危的最简单及最好的方法之一，请一定要按时数好。医生每天查房时检查每天的胎动数。 左侧卧位:可防止右旋的子宫压迫腹腔大血管影响回心血量，避免胎儿缺氧。 间歇吸氧:每天早上、下午一次，每次半小时，这样可增加胎儿血氧浓度。 前置胎盘的健康教育 反复无痛性阴道流血是前置胎盘典型的症状，如果你在妊娠期出现这样的症状应立即到医院检查。 1、要绝对卧床休息，少活动，因活动会使阴道出血增多，危及母婴生命。 2、多次的出血，容易引起贫血，机体抵抗力降低，你应多食含蛋白质及维生素的食物(如肉类、鱼类、牛奶、鸡蛋、水、动物肝脏等)。 3、自数胎动，自我监测胎儿宫内情况。 4、左侧卧位，间歇吸氧都可增加母体血氧浓度，使供给胎儿的氧气及营 closed staff) provide cool summer drugs such as mung bean soup, to ensure safety and health. In special circumstances (such as open,post eason, put an end to common disease epidemic. In increasing nutrition to workforce (especially a first line of production andve measures, ensure employee health and the smooth progress of the project. 8.3.2.2 concrete measures (1) during the summer sffectin site management and staff management responsibility to the people, careful supervision, responsibility to the people, and eonstruction, focus on work safety, cooling, and disease prevention. 8.3.2.1 preparations during the summer season constructioooth con, high temperatures in the summer season, the construction process, to ensure the safety and health of workers, ensuring smafety. High temperature construction measures for Zhuhai area in summer high temperatures, the characteristics of long duratimine svide physical protection. (6) do lightning protection lightning protection, and conduct a comprehensive inspection to ensure eason construction materials used and the entry of machinery and spare parts, for the smooth start of the rainy season to proemand organization ahead in rainy sweather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to the project d6 养也相就增加。 5、每天外阴擦洗两次，以保持外阴清洁，减少感染机会，安胎药有时会引起心跳加快等不适，这是药物的正常反应，请不要担扰。 6、进食高纤维、高维生素食物，养成定时排便的习惯，防便秘。 早期破膜的健康教育 临产前破膜者称为胎膜早破。主要现为有大量水样液体从阴道流出。胎膜早破可诱发早产及增加宫内感染和产褥感染，入院后你应: 1、卧床休息，左侧卧并抬高臀部。防止脐带脱出。 2、保持外阴清洁，护士为你每天冲洗两次，并用消毒巾保护。 3、破膜超过12小时将予抗菌药，破膜后24小时未临产且已足月者，给予引产，未足月者(少于37周)，给予安胎，注意:流出羊水的颜色，正常为无色透明，如变为绿色，表示胎儿缺氧，立即通知医护人员。 妊娠高血压综合症的健康教育 本症是妊娠期特发病，表现为妊娠后期发生高血压，水肿和蛋白尿，严重时可出现头痛、眼花、胸闷甚至抽搐和昏迷，可危及母婴生命。 入院后的注意事项: 1、注意多休息，每天保持10小时以上，左侧卧位为主。 2、保持良好的心境和病房安静，必要时，我们会为您安排一间光线较暗的房间或戴黑眼罩，以防声光刺激。 3、多进食高蛋白质、高维生素、含铁、钙、锌的食物(如鱼、肉、蛋、蔬菜等)不食过咸的食物，避免水肿加重。 4、按要求每天自数胎动三次，自我监测胎儿宫内情况及时发现胎儿缺氧。 5、左侧卧位，间歇吸氧使供给胎儿的氧气和营养增加，利于胎儿生长。 6、根据病情医生会决定每天测血压次数。 7、口服降压、镇静药(心痛定、安定等)轻症者经上述处理病情多可缓 health. In special circumstances (such as open, closed (especially a first line of production and post staff) provide cool summer drugs such as mung bean soup, to ensure safety andforce .3.2.2 concrete measures (1) during the summer season, put an end to common disease epidemic. In increasing nutrition to workision, responsibility to the people, and effective measures, ensure employee health and the smooth progress of the project. 8uperveparations during the summer season construction site management and staff management responsibility to the people, careful ssafety and health of workers, ensuring smooth construction, focus on work safety, cooling, and disease prevention. 8.3.2.1 pr re thetemperatures, the characteristics of long duration, high temperatures in the summer season, the construction process, to ensuduct a comprehensive inspection to ensure mine safety. High temperature construction measures for Zhuhai area in summer high d confor the smooth start of the rainy season to provide physical protection. (6) do lightning protection lightning protection, an the project demand organization ahead in rainy season construction materials used and the entry of machinery and spare parts,weather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to 7 解。 8、病情需要时会给予静脉用药，硫酸镁是一种解痉降压药，静脉滴注期间，请勿自行调整滴速。如果您发现尿量明显减少或呼吸困难，应及时告诉医护人员，个别会有少汗头痛，全身发热，这是药物的反应，通过调慢滴速可减轻这些不适。 9、如果出现头晕、眼花、恶心、呕吐、胸闷、睡眠不好，腹痛等不适，要及时通知医护人员避免后果出现。 妊娠合并甲亢如何配合治疗 1、病情未控制前，应卧床休息，保证充足睡眠，避免神经刺激。 2、进食高热量，高碳化合物，高维生素饮食，多饮水，禁饮浓茶、咖啡等刺激性饮料，勿食含碘丰富的海带、紫菜及海产品等。 3、药物在医生指导下使用，剂量不能自行增减，更不能自行停药。 4、用药期间不宜喂奶。 5、若出现发热，心率加快，烦躁不安等不适，要及时通知医生。 妊娠合并糖尿病的健康教育 妊娠合并糖尿病孕妇由糖代谢紊乱以致严重影响母婴健康，应自觉配合医生治疗，首先控制饮食，戒糖、炼奶。轻型糖尿病通过饮食可控制血糖浓度，一般要进行血、尿糖测定，护士会告诉您测血、尿糖的时间，请您做好配合。注意个人卫生，预防感冒，保持外阴清洁，由于糖尿病时，白细胞杀菌作用降低，易发生各部位的感染，如皮肤溃烂，阴道炎等。 糖尿病孕妇的胎儿宫内缺氧及胎儿发育异常发生率增高，为了更好地监测胎儿宫内情况，我们将定时听胎心音，必要时进行胎监，B超、脐血流等相关检查，请你一定要认真数胎动。 当饮食不能控制糖时，常需使用胰岛素进行治疗，用法:在进食前半小时皮上注射，注射后一定要按时进食，否则出现低血糖症状(饥饿心慌、头昏、出冷汗等)无论进食糖尿病餐或使用胰岛素，要注意低血糖的发生，一 staff) provide cool summer drugs such as mung bean soup, to ensure safety and health. In special circumstances (such as open,post eason, put an end to common disease epidemic. In increasing nutrition to workforce (especially a first line of production andve measures, ensure employee health and the smooth progress of the project. 8.3.2.2 concrete measures (1) during the summer sffectin site management and staff management responsibility to the people, careful supervision, responsibility to the people, and eonstruction, focus on work safety, cooling, and disease prevention. 8.3.2.1 preparations during the summer season constructioooth con, high temperatures in the summer season, the construction process, to ensure the safety and health of workers, ensuring smafety. High temperature construction measures for Zhuhai area in summer high temperatures, the characteristics of long duratimine svide physical protection. (6) do lightning protection lightning protection, and conduct a comprehensive inspection to ensure eason construction materials used and the entry of machinery and spare parts, for the smooth start of the rainy season to proemand organization ahead in rainy sweather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to the project dclosed 8 旦出现低血糖症状要及时通知医护人员。 妊娠合并心脏病 从孕2个月起，母体血容量就开始增加，整个孕期血量约1500ml，一般情况下健康孕妇可通过调节来适应，但对于原有心脏病的孕妇，心脏负担增加极易使心脏功能进一步减退而引起心衰，严重威胁母婴安全。妊娠合并心脏病的孕妇应提前入院待产，并注意以下事项: 1、绝对卧床休息，每天睡眠时间应在10小时以上，减轻心脏的负担。 2、保持心境开朗，消除顾虑、恐惧心情，对心脏病有好处。 3、注意保暖，避免受凉，因受凉感冒容易引起呼吸道感染，而增加心脏负担。 4、吃易消化含丰富蛋白质(肉类、鱼类、牛奶)、维生素(水果、蔬菜)的食物，宜低盐饮食尽量少量多餐，整个妊娠期体重不超过10kg。 5、左侧卧位或半卧位，间歇吸氧，增加供给胎儿的氧气及营养。 6、如有胸闷，心慌、气促等不适，应立即医务人员，因这是病情加重的表现，需立即处理。 (especially a first line of production and post staff) provide cool summer drugs such as mung bean soup, to ensure safety andforce .3.2.2 concrete measures (1) during the summer season, put an end to common disease epidemic. In increasing nutrition to workision, responsibility to the people, and effective measures, ensure employee health and the smooth progress of the project. 8uperveparations during the summer season construction site management and staff management responsibility to the people, careful ssafety and health of workers, ensuring smooth construction, focus on work safety, cooling, and disease prevention. 8.3.2.1 pr re thetemperatures, the characteristics of long duration, high temperatures in the summer season, the construction process, to ensuduct a comprehensive inspection to ensure mine safety. High temperature construction measures for Zhuhai area in summer high d confor the smooth start of the rainy season to provide physical protection. (6) do lightning protection lightning protection, an the project demand organization ahead in rainy season construction materials used and the entry of machinery and spare parts,weather information in order to advance prevention of inclement weather such as rainstorm hit. (5) according to health. In special circumstances (such as open, closed 9