Cardiovascular Changes in pregnancy
Total Questions : 4
Showing 4 questions, Sign in for moreA nurse is reviewing the cardiovascular changes in pregnancy with a group of nursing students.
Which of the following statements by a student indicates a need for further teaching?
Explanation
The hemoglobin concentrationdecreasesby 15% to 25% during pregnancy due to hemodilution.
This is known as physiological anemia of pregnancy.
Choice A is wrong because the cardiac outputincreasesby 30% to 50% during pregnancy to meet the increased metabolic demands of the mother and fetus.
Choice B is wrong because the blood pressuredecreasesby 10 mmHg during pregnancy due to systemic vasodilation.
It returns to pre-pregnancy levels postpartum.
Choice D is wrong because the venous pressureincreasesduring pregnancy due to increased blood volume and compression of the inferior vena cava by the gravid uterus.
This can lead to lower extremity edema and varicose veins.
Answer and explanation..
The correct answer is choice C.The hemoglobin concentrationdecreasesby 15% to 20% during pregnancy due to the increase in plasma volume.This is known asphysiological anemiaof pregnancy.
Choice A is wrong because the cardiac outputincreasesby 30% to 50% during pregnancy to meet the increased metabolic demands of the mother and fetus.
Choice B is wrong because the blood pressuredecreasesby 10 mmHg during pregnancy due to the decrease in systemic vascular resistance.It gradually returns to pre-pregnancy levels by term.
Choice D is wrong because the venous pressureincreasesduring pregnancy due to the compression of the inferior vena cava by the gravid uterus.This can lead to lower extremity edema and varicose veins.
A nurse is caring for a pregnant client who has a hemoglobin level of 10 g/dL and a hematocrit level of 32%.
Which of the following explanations should the nurse give to the client?
Explanation
These levels are normal due to physiological anemia of pregnancy.Physiological anemia of pregnancy is a reduction in the concentration of hemoglobin or hematocrit in blood due to an increase in blood volume.The normal range of hemoglobin during pregnancy is11 to 16 g/dLand the normal range of hematocrit during pregnancy is32% to 42%.The minimum normal value of hemoglobin is11 g/dLin the first and third trimester and10.5 g/dLin the second trimester.
Choice B is wrong because these levels are not low enough to indicate iron deficiency anemia, which is the most common cause of anemia in pregnancy.Iron deficiency anemia is diagnosed when hemoglobin is below10.5 g/dLor hematocrit is below30%.
Choice C is wrong because these levels are not high enough to indicate polycythemia, which is a rare condition of increased red blood cell mass.Polycythemia is diagnosed when hemoglobin is above18 g/dLor hematocrit is above54%.
Choice D is wrong because these levels are not abnormal enough to indicate hemolysis, which is a destruction of red blood cells.Hemolysis can cause severe anemia and jaundice in pregnancy and may be associated with infections, autoimmune disorders, or blood transfusions.
A nurse is caring for a client who is at her first prenatal visit and reports that she has been experiencing episodes of hypotension since becoming pregnant.
Which of the following responses by the nurse is appropriate?
Explanation
This is due to an increase in blood volume caused by pregnancy.According to Healthline, pregnancy causes many changes in a woman’s body, including expanding blood vessels to let blood flow to the uterus.
This can lower the blood pressure, especially in the first and second trimester of pregnancy.
Choice B is wrong because an increase in cardiac output would raise the blood pressure, not lower it.
Cardiac output is the amount of blood pumped by the heart per minute.
Choice C is wrong because an increase in body weight would also raise the blood pressure, not lower it.
Body weight affects the amount of resistance in the blood vessels.
Choice D is wrong because an increase in pressure on the diaphragm would not affect the blood pressure directly.
The diaphragm is a muscle that helps with breathing, not with circulation.
Normal blood pressure levels during pregnancy are less than 120/80 mmHg.Low blood pressure is usually diagnosed when the reading is around 90/60 mmHg or lower.Low blood pressure during pregnancy does not usually cause significant health issues, but it can cause symptoms such as dizziness, fainting, nausea, or fatigue.In some cases, very low blood pressure can be dangerous for the mother and the baby.
Therefore, it is important for pregnant women to have regular check-ups with their doctor and report any symptoms of low blood pressure.
A nurse is educating a pregnant client about the musculoskeletal changes during pregnancy.
Which hormone is primarily responsible for increasing joint laxity?
Explanation
Relaxin is primarily responsible for increasing joint laxity during pregnancy.
Relaxin is a hormone that is produced by the corpus luteum and the placenta, and it helps to soften and widen the cervix and the pubic symphysis for childbirth.Relaxin also affects other joints and ligaments throughout the body, making them more flexible and prone to injury.
Choice B is wrong because progesterone is not directly involved in joint laxity, although it does have other effects on the musculoskeletal system, such as increasing bone resorption and decreasing muscle strength.
Choice C is wrong because estrogen is not directly involved in joint laxity, although it does have other effects on the musculoskeletal system, such as increasing bone formation and modulating pain perception.
Choice D is wrong because human chorionic gonadotropin (hCG) is not directly involved in joint laxity, although it does have other effects on the musculoskeletal system, such as stimulating thyroid function and increasing fluid retention.
Normal ranges for these hormones vary depending on the stage of pregnancy, but generally they increase throughout gestation and peak near term.
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