a. Dyspnea.

(1) Dyspnea is caused by the limited expansion of the diaphragm by the enlarging uterus. It may be an increased sensitivity to or compensation for slight acidosis (“breathing for two”).

(2) Dyspnea may be very troublesome in the last weeks of pregnancy. The patient may have difficulty sleeping.

(3) Nursing interventions consist of advising the patient to:

(a) Sleep on additional pillows.

(b) Maintain good posture.

(c) Avoid overeating.

(d) Stop or decrease smoking.

(e) Limit activity before becoming dyspenic.

(f) Decrease anxiety by concentrating on slow, deep breaths.

(4) Dyspnea of sudden onset in patients who are known to have heart disease may be a sign of impending heart failure. The physician should be notified immediately.

b. Nasal Stuffiness. Nasal stuffiness is caused by increased vascularization due to the increase in hormone. It is not preventable; functioning of the nasal will return to normal after delivery.