Fundamentals of Nursing Q 359
A woman who is six months pregnant is seen in antepartal clinic. She states she is having trouble with constipation. To minimize this condition, the nurse should instruct her to
A. Increase her fluid intake to three liters/day.
B. Request a prescription for a laxative from her physician.
C. Stop taking iron supplements.
D. Take two tablespoons of mineral oil daily.
Correct Answer: A. increase her fluid intake to three liters/day.
In pregnancy, constipation results from decreased gastric motility and increased water reabsorption in the colon caused by increased levels of progesterone. Increasing fluid intake to three liters a day will help prevent constipation. The client should increase fluid intake, increase roughage in the diet, and increase exercise as tolerated.
Option B: Laxatives are not recommended because of the possible development of laxative dependence or abdominal cramping. The primary medical treatment for constipation in pregnancy is a medication called a laxative, which makes it easier and more comfortable to go to the bathroom. It is generally safe to use gentle laxatives, but it is best to avoid stimulant laxatives because they can induce uterine contractions.
Option C: Iron supplements are necessary during pregnancy, as ordered, and should not be discontinued. Daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron and 400 µg (0.4 mg) folic acid is recommended for pregnant women to prevent maternal anemia, puerperal sepsis, low birth weight, and preterm birth.
Option D: Mineral oil is especially bad to use as a laxative because it decreases the absorption of fat-soluble vitamins (A, D, E, K) if taken near mealtimes. Mineral oil should always be prohibited during pregnancy, as its use can cause hemorrhagic disease of the newborn due to impaired absorption of vitamin K. Similarly, castor oil is absolutely prohibited during pregnancy.