NUR 3122

OBSTETRIC NURSING

TOPIC: Frequency of Micturition During

Pregnancy and Nursing Management
GROUP 2

Nurul hamidah khairul anwar

1317592
Anis Hafizah bt Mat
1310034
Nik Hazwani Ayuni Bt Nik Mohamad Hasri 1319460
Nur Afikah Binti Ramli
1312208
Nor Azzieana Zambri

1313022

INTRODUCTION
Pregnancy induces a variety of anatomical and
physiological changes in the urinary tract
Kidneys enlarge in size by > 1cm.Dilatation of
renal pelvis causing hydro-ureter occurs, as
early as 7 weeks of pregnancy.
Normal non pregnant woman voids four to six
times during day and rarely at night
As pregnancy progresses, the blood volume
increases nearly 50 percent over its prepregnancy level. This extra fluid gets processed
through kidneys and ends up in the bladder and
the mother are off to the bathroom again.

FREQUENCY OF MICTURITION INCREASE

DURING PREGNANCY AS THE UTERUS
GROWS TO ACCOMMODATE THE BABY, IT
PRESSES AGAINST BLADDER, WHICH SITS
IN FRONT OF AND SLIGHTLY BELOW IT

ETIOLOGY
Blood volume increases during pregnancy
Body produces a pregnancy hormone known as
hCG ( human chorionic gonadotropin) which can
trigger an increase in urination.
Uterus expands, pushing down on the bladder,
urethra, and pelvic floor muscles
In preparation for delivery

PATHOPHYSIOLOGY
1. HORMONE
2. BLOOD VOLUME
3. PRESSURE

HORMONE

Embryo
implanted

Body produce
pregnancy
hormone hCG
( human
chorionic
gonadotropin)

More blood
flow to the
pelvic area,
more blood
pass through
the kidney

Trigger
urination in
the first
trimester of
pregnancy

BLOOD VOLUME

As pregnancy
progresses, blood
volume increases
nearly 50 percent
over its prepregnancy level

Blood circulated is
processed by the
kidney

Increase of urine as
the blood volume
increases

PRESSURE
As baby grows, uterus will expands,
pushing down on the bladder, urethra,
and pelvic floor muscles

pressure on the bladder can cause some

pregnant women to experience stress
urinary incontinence

In the end of pregnancy, urination

situation may worsen a bit as the baby
moves lower (in preparation for delivery)
and puts added pressure on the bladder

COMPLICATIONS

ASSESSMENT
History
Pain symptoms
Medical history
Past complication of
pregnancy
Recent sexual history
Method of
contraception

Examination

Abdominal/pelvic tenderness, guarding

Enlarged bladder.
Vaginal discharge,

Genital herpes simplex or vaginitis.

NURSING MANAGEMENT
Nursing

Goal

Nursing Interventions

Rationale

Patient will be
less complain of
frequent
micturition.

1. Assess client's pattern

of fluid intake and
urination
2. Monitor intake and
output chart 4 hourly
3. Teach client on how to
do Kegel exercise
4. Encourage client to
drink a minimum of
1,500 mL fluids per
day
5. Teach client to
maintain hygiene at
the perineal area to
prevent urinary tract
infection.

1. To obtain
baseline data.
2. To identify
any changes
amount of
intake and
output.
3. To improve
strength of the
pelvic floor
muscle.
4. To prevent
dehydration

Diagnosis
Impaired Urinary
Elimination
related to
antenatal
physiological
changes as
evidence by
patients
complaint of
frequent
micturition

Nursing
Diagnosis
Risk for fluid
volume deficit
related to
frequency of
micturition
during
pregnancy.

Goal

Nursing

Rationale

Intervention
The client will 1. Assess patient
1. To find out the less
not experience
appearance such as
interstitial fluid /
fluid volume
skin turgor and
loss can lead to loss
deficit.
moist oral mucosa.
of skin elasticity.
2. Record input and
2. To find out the
output chart.
balance of fluids in
the body that are
needed for daily
3. Observed
metabolism.
temperature and
3. Dry mucous
mucous
membranes which is
membranes.
an indicator of
dehydration.
4. Monitor the
4. The reduced amount
production of
of urine as
urine.
indicators of

HEALTH EDUCATION
Drink sufficient plain water to keep hydrated.
Avoid caffeinated drinks such as coffee and tea
that have a diuretic effect
Empty the bladder completely by leaning forward
when urinate
Encourage easy-to-do Kegels exercises ( while
driving, watching TV, messaging) will strengthen
the pelvic floor muscles.
Take care of perineal hygiene to prevent
infection.
Educate patient about sign and symptoms of UTI
to avoid further complications.

CONCLUSION & ISLAMIC PERSPECTIVES

Urinary symptoms are universal during pregnancy.
Most problems are simple like voiding difficulties, increase in
frequency and urgency.
Serious disorders are very uncommon but an obstetrician
should be on the look out for individual urological problems
presenting for the first time in pregnancy
Pregnancy is a beautiful thing. The bringing of forth life in
ones womb is both spiritual and emotional. A mother having
such a connection with their unborn is a fascinating event.
But let us face it, this is also a time of frequent urination,
backache, leg cramps, bleeding gums and hair loss.
In the the Qur'an a pregnant woman is literally referred to as
one with a burden:
and every pregnant woman (dhat haml) will drop her
burden (22:2)

REFERENCES
1. Anbrin Salick, Arif Tajammul, Shahida Sheikh Javed Iqbal, Nazish
Razzaq And Sarosh Wazir (2005). Frequency Of Urinary Symptoms In
Pregnancy. Retrieved on 9 October 2015 from
http://www.thebiomedicapk.com/articles/27.pdf
2. The bump from the knot. (n.d.). Signs Of Pregancy: Frequent Urination.
What Are the Causes of Frequent Urination? Retrieved on 10 October
2015 from http://www.thebump.com/a/frequent-urination.
3. What to Expect. (2014). Frequent Urination During Pregnancy. What
cause it. Retrieved on 10 October 2015 from
http://www.whattoexpect.com/pregnancy/symptoms-andsolutions/frequent-urination.aspx
4. William R., (2011). Frequent Urination Causes. What are the potential
complications of frequent urination? Retrieved on 10 October 2015 from
http://www.healthgrades.com/right-care/overactive-bladder/frequenturination--causes