LESSON PLAN

ON

ANTENATAL AND POSTNATAL

EXERCISE

SUBMITTED TO: SUBMITTED BY:

DR.G.BHUVANESHWARI Dhinesh.M
SAVEETHA COLLEGE OF NURSING B.SC (N) IV YR
SAVEETHA UNIVERSITY SAVEETHA COLLEGE OF NURSING

TOPIC- ANTENATAL AND POSTNATAL EXERCISE.

DATE-

TIME –

VENUE-

METHODS OF TEACHING - HEALTH EDUCATION

AUDIO-VISUAL AIDS- FLASH CARDS

NAME OF THE GUIDE- DR.G.BHUVANESHWARI

NAME OF THE TEACHER – DHINESH.M

SUBJECT-COMMUNITY HEALTH NURSING II

GENERAL OBJECTIVE:

AT THE END OF PRESENTATION, GROUP WILL BE ABLE TO UNDERSTANDING THE ANTENATAL AND
POSTNATAL EXERCISE

SPECIFIC OBJECTIVES:
AT THE END OF PRESENTATION, GROUP WILL BE ABLE TO-
 DEFINE OR TELL THE MEANING OF ANTENATAL AND POSTNATAL EXERCISE
 CLASIFY THE ANTENATAL AND POSTNATAL EXERCISE
 KNOW REQUIREMENT OF IRON FOR DIFFERENT AGE GROUPS.
 EXPLAIN CAUSES AND CLINICAL FEATURES OF NUTRITIONAL DEFICIENCY ANAEMIA
 EXPLAIN ASSESMENT AND DIAGNOSTIC FINDINGS.
 DESCREIBE THE TREATMENT OF NUTRITIONAL DEFICIENCY ANAEMIA
S. N. SPECIFIC TIME CONTENT TEACHING A.V. LEARNERS
OBJECTIVE ACTIVITY AIDS ACTIVITY

INTRODUCTION:

03 Antenatal exercise aims at preventing low back pain

mins and enhancing physical and psychological
preparation for delivery by means of joint stretching
and muscle strengthening. - Tighten the vaginal,
urethral and anal muscles as if trying to withhold
urination or defecation.
1 Group will be 05 Explain using Flash Listening and
able to define mins flash cards cards asking
anemia. DEFINITION:- questions
Antenatal exercise aims at preventing low back pain
and enhancing physical and psychological
preparation for delivery by means of joints
stretching and muscle strengthen. ... Note : this
2 Group will be 10
able to mins exercise helps you by correcting the low back and
classify pelvic posture Explain using
anemia. flash cards
GUIDELINES FOR ANTENATAL EXERCISE

﹣ Breathe smoothly, work gradually

according to your capability

﹣ Work twice or thrice a day and repeat each

set of movements ten times in

every session

﹣ Antenatal exercise may begin when

pregnancy reaches 16 to 20 weeks

﹣ Physiotherapist may make modifications to

the exercise according to your

physical conditions

Note: This leaflet is only a brief introduction to

antenatal exercise
 III. Types of antenatal exercise
Flash
Group will be Explain using Card Listening and
3 able to know flash cards asking
(1) Pelvic floor exercise
the 10 questions
requirement mins
of iron in
different age ﹣ Sit on a chair with your back
groups.
against the seatback

﹣ Tighten the vaginal, urethral

and anal muscles as if trying to withhold urination
or defecation. You can also do this exercise in a
standing

position.

Pelvic floor exercise enhances the control and

support of pelvic floor

Flash
muscles. It helps you prepare for childbirth and Explain using cards
4 Group will be 10 prevents uterine prolapse, urinary incontinence and flash cards Listening and
able to mins asking
explain haemorrhoid. questions
 clinical
features.
2.Back and abdominal exercise

﹣ Sit on a chair with your back

against the seatback

﹣ Breathe naturally
Flash
5 Group will be 15 Card Listening and
able to mins Discussion asking
﹣ Tighten the abdomen and
explain causes Explain using questions
of anemia. then press the pelvis flash cards

downwards to flatten your low back against the

seatback. Hold for 5 seconds, and relax

This exercise helps you by correcting

the low back and pelvic posture. It

strengthens your abdominal muscles

 and prevents back pain.

(3) ANKLE EXERCISE.

﹣ Sit on a chair with your back

against the seatback

﹣ Start with one ankle and turn

the foot upwards and downwards. Each

up-and-down movement is counted as one time.

Repeat ten times
6 Group will be 10
able to mins
explain Explain using
﹣ Rotate the ankle to draw an
assessment flash cards Flash Listening and
and diagnostic inward or outward circle. Each circular cards asking
findings. questions

movement is counted as one time. Repeat ten times

﹣ Repeat the same steps at the

 other ankle

﹣ Ankle exercise helps reduce

leg swelling and varicose vein, thus

alleviating the problem of leg cramps

7 Group will be 15
able to mins (4) Lower limbs relaxation
describe
treatment. exercise Explain using
flash cards Flash Listening and
Card asking
questions
﹣ This exercise enhances the
flexibility

and strength of inner thighs and pelvic

muscles. It helps you get accustomed

to the delivery position and prevent thigh

spasm during delivery

﹣ Sit on a stable low chair

against a wall and

spread your thighs sideways. Hold for 5

seconds and relax

Note: 1. It is suitable for pregnant women with

tight thighs

2. Do not pull apart the thighs

3. Please note that this exercise is not

suitable for those with pain over the pubic

bones
(5) Breathing exercise

﹣ Breathing techniques for

pain relief

during labour. Exhale before inhale is

suggested

A. Abdominal breathing

﹣ Suitable for mild

pain

﹣ Breathe in through
the nose and feel

the abdomen expand. Then breathe

out through the mouth

B. Lower costal breathing

﹣ Suitable for medium

pain

﹣ Put your hands on the

lower rib cage.

Breathe in through the nose and feel

your chest expand. Then breathe out

lightly through the mouth.

C. Apical breathing

Subsequent Visits

﹣ Suitable for severe

pain

﹣ Cross your hands below the

clavicles with your mouth slightly

open. Breathe in through the

nose and the mouth. Breathe

out lightly as if trying to flicker the

flame of a candle without blowing

it out, and feel the upper lungs

moving slightly up and down

* During contractions, try to relax

and control your breathing

* In between contractions, rest

and relax as much as you can in

the most comfortable position.

.
 Muscle pain or cramping
 Cardiac and pulmonary disease
 Anorexia
 Giddiness
 Swelling of legs
CAUSES OF ANEMIA
Iron deficiency anemia is very much prevalent in
the tropics particularly amongst women of the child
bearing age, specially in the under privileged sector.
I. Faculty dietetic habit:- there is no
deficiency of iron in the diet but the diet is
rich in carbohydrate high phosphate and
phytic acid help in the formulation of
insoluble iron phosphate and phytic in the
gut, there by reducing the absorption of
iron.
II. Faculty absorption mechanism because
of high prevalence of intestinal infestation,
there is intestinal hurry which reduces the
iron absorption, hypochlorhydaria often
associated with malnutrition also hinder
absorption.
III. Iron loss
 More iron is lost through sweat to the
extent of 15mg/month
 Repeated pregnancies of short intervals.
  Excessive blood loss during menstruation.
 Hook worm infestation.
 Chronic malaria.
 Bleeding piles and dysentery.
ASSESSMENT AND DIAGNOISIS FINDING
 HB, hematocrit, reficulocyte count, red cell
incise, MCV evaluation.
 Iron studies (serum iron level, total iron
binding capacity), percent saturation and
fortune.
 Vit. B12 deficiency test
 Erythropoietin level
 CBC test
 Bone marrow aspiration
 Urine and stool examination
PROPHYLACTIC
The prophylactic includes
1. Avoidance of frequent child birth
2. Supplementary iron therapy
3. dietary prescription- the foods rich in
iron are liver, meat, eggs, green
 vegetables, green peas, fish, whole wheat,
Green plantains, onion, jiggery etc.
4. Adequate treatment: It should be
instituted to eradicate the illness likely to
Cause anemia. These are hookworm
infestation, dysentery, malaria, bleeding
piles, urinary tract infection latent as
Overt.
5. Early detection of falling HB level is to
be made.
 General treatment
1. Diet:- realistic balanced diet which is rich in
protein, ion and vitamin which is easily
assimilate is prescribed.
- To improve the appetite and facilities digestion-
dilute HCL acid 2ml along with twice the
amount of glycerin acid pepsin may be given
TDS after meal.
- To eradicate even a minimal septic focus by
appropriate antibiotic therapy.
- Effective therapy to cure the disease
 contributing to the cause of anemia.
2. specific therapy
The principle is to raise the HB level as near to
normal as possible.
IORN THERAPY
- oral therapy
- potential therapy

IRON SUPPLIMENTATION
Several iron preparation- ferrous sulfat, ferrous
glunate &ferrous fumarate –are available for
treating iron deficiency anemia. One tablets of
iron sulfate provide 60 mg of elemental iron. Thus
it is important to continue iron for as long as 6-12
month..
In some cases, oral iron is poorly
absorbed or poorly tolerated or needed in large
amount. In this situation IM or IV of iron dextron
may be needed. Iron dextron should be injected
deeply into each buttock using the z track
technique.
 NURSING MANAGEMENT
- Preventive education is important because iron
deficiency anemia is common in menstruating
and pregnant women.
- Taking iron rich food with a source of vit-C
enhances absorption of iron.
- Nutritional counseling can be providing.
- The nurse encourage patient to continue
Iron therapy as long as is prescribed.

Outcome management
1.Vitamin B-12
Client with pernicious anemia need both immediate
and life long therapy with maintenance of vitamin
B-12.during the acute phase of illness, client may
be given vitamin B12 injection. Peripheral nerve
function may improve the treatment.
2.iron supplement
Injection of vitamin B-12 may cause rapid
regeneration of RBC that depletes iron.
3.folic acid
It is some time given with vitamin B-12 to client
with a history of poor nutrition.
4.digestants
Dagestan’s to enhance the metabolism of vitamin
such as HCL diluted in water and given with meal,
are often used during the first few weeks of vitamin
B-12 therapy.

FOLIC ACID DEFICIENCY ANAEMIA

Anemia associated with folic acid deficiency is very
common.
Causes-
1. Inadequate intake of folic acid.
2. Increased demand.
3. diminished absorption.
4. Abnormal demand.
5. Failure of utilization.
6. diminished storage.
Clinical manifestation
1.pallor
2. Ulceration of mouth.
3. enlarged liver and spleen.
4. Thin and emaciated client.
5. Cirhosis of liver.
OUTCOME MANAGEMENT

For correction of anemia caused by Folate

deficiency, the client receives oral dose of folic acid
0.1-5 mg/day until blood profile improved or until
the cause of intestinal malabsorption corrected.
Client with malabsorption may need parenteral folic
acid initially followed by matainance therapy with
oral doses. Folic acid is administered IM in form of
folinic acid.additionaly vitamin C is sometime
prescribed because it increase the role of folic acid
in promoting erythropoiesis.

CONCLUSION

Nutritional deficiency anemias are common in

females in reproductive age groups. This increases
the mortality rates in females in India. So
 preventive measures are very important to cure the
anemia in females.

SUMMARY:
 So far we have discussed about definition of anaemia, itsclassification,requirement of iro at different ages and causes,
clinical manifestations, assessment and findings and treatment of deficiency anaemia

BIBLIOGRAPHY

 Black M. Joyce, Medical Surgical Nursing,Volume-2,6th Edition,Pp-2103-2105

 Brunnner And Suddarths,Medical Surgical Nursing, 9th Edition,Pp-741-742.

 Dutta D. C,Obstetrics And Midwifery,Pp-273-275.

 Park textbook, community medicine pp-241 -248

 Joshi Shubhangini A, Nutrition And Dietetics,2nd Edition.Pp-273.390.