of care that suits the client’s lifestyle To develop a trusting relationship. Discussion of pica practices should be based on a nonjudgmental model, for pica may have strong cultural implications, and may be practiced for cultural reasons unknown to the nurse. The nurse is assigned to clients who are having the following procedures: amniocentesis, fetal nonstress test, chorionic villus sampling, percutaneous umbilical blood sampling, and Doppler assessment of fetal heart rate. It is not clear that patients volunteer information about pica, so it would be helpful if nurses queried patients at each prenatal visit regarding pica practice. Although this study did not show specific pregnancy complications associated with pica, other studies have shown anemia and lead poisoning among women who practice pica. Pica exists, and might be more common than healthcare providers assume. No specific pregnancy complication was associated with the practice of pica. Women reporting daily pica practice were significantly more likely to have lower prenatal hematocrits than women who did not practice pica, or who practiced pica less frequently than daily. Women practicing pica were more likely to have been underweight prior to pregnancy, and smoked fewer cigarettes. Polypica (ingestion of more than one substance) was practiced by 11 women. Substances ingested included ice (>1 cup/day), freezer frost, laundry starch, cornstarch, clay dirt, and baked clay dirt. African-American women reported practicing pica more often than other ethnicities. Thirty-eight percent of these pregnant women practiced pica. Demographic and sociocultural variables, pica practices, pica substances ingested, and pregnancy outcomes were collected. Prospective, descriptive, correlational investigation with 128 women who sought prenatal care from two rural community health agencies. To discover the prevalence of pica, the documentation of pica on medical records, and any relationship of pica to pregnancy outcomes in rural socioeconomically disadvantaged pregnant women.
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