8-2. Discomforts Related to the Musculoskeletal System
- (1) Backache is caused by relaxation of the sacroiliac joint which is due to increased hormones (steroid sex hormone and relaxing) resulting in slight joint and muscle relaxation and increased mobility; and exaggerated lumbar and cervico thoracic curves caused by changes in the center of gravity from the enlarging abdomen and breasts.
- (2) Prevention of strain, which can cause backache, should begin early in pregnancy.
- (3) Nursing interventions consist of advising the patient:
- (a) That maternity girdles are no longer recommended.
- (b) To practice good posture and good body mechanics (use the pelvic tilt and bend at the knees).
- (c) To wear appropriate, well-fitting shoes.
- (d) To sleep on a firm mattress or backboard.
- (e) That backaches may indicate a kidney or bladder infection. The patient must inform the physician of backache problems. Backaches should be carefully evaluated.
b. Muscle Cramps.
(1) Muscle cramps are caused by:
- (a) Compression of nerves supplying the lower extremities due to the enlarging uterus.
- (b) Reduced level of diffusible serum calcium or elevation of serum phosphorus in the bloodstream.
- (c) Fatigue, chilling, or tense body posture.
- (2) Muscle cramps are not considered a serious condition, but they may be quite painful.
- (3) Nursing interventions consists of advising the patient to:
- (a) Avoid fatigue and cold legs.
- (b) Eat a diet with adequate calcium or prescribed calcium.
- (c) Avoid drinking more than one (1) quart of milk per day. More than one quart of milk per day will create too much phosphorus in the system.
- (d) Take the prescribed vitamins B and D per doctor's instructions.
(4) Treatment during muscle cramps.
- (a) The patient should lie on her back and extend the affected limb. A second individual should apply pressure on the patient's knee with one hand and sharply flex the foot with the other hand (see figure 8-1). The affected muscle may also be kneaded with the heel or palm of the hand.
- (b) Heat may be applied to the area of the muscle cramp.
Figure 8-1. Relief of muscle cramp.