These are series of information given by the midwife to a pregnant client/woman on how to cope and manage the pain associated with haemorrhoids and prevention of constipation which is major contributing factor.
Aims
· Aid in free bowel elimination
· Prevent infection
· Reduce associated pain
· Prevent anal fistula in severe cases
· Prevent complications such as anaemia
· Promote comfort
Types
· Individual education
· Group education
Steps
1. Establish rapport (refer steps)
2. Provide privacy and ensure client assume desired position
3. Explain to client the need to attend antenatal clinic and procedures involved
4. Explain the possible cause of haemorrhoids in pregnancy to her
5. Apply cold packs to the anal region with cotton wool or gauze
6. Educate client to use padded sits to help reduce anal pain
7. Encourage client to perform warm sitz bath to help reduce engorgement
8. Counsel client to elevate legs and the lower pelvis to facilitate venous return
9. Educate client on measures to prevent constipation (high fibre diet, increase intake of fluids, mild exercise etc.)
10. Encourage client to apply soothing ointment (e.g. anusol)
11. Advice client to report to the clinic in case of severe constipation and bleeding
12. Encourage client to ask questions and give appropriate answers
13. Emphasize the need for client to adhere to information given
14. Express appreciation of client for her cooperation
15. Record and report all information in the Maternal and Child Health Book (Manual or Electronic)
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