Anatomy and Physiology of Pregnancy

Anatomy and Physiology of Pregnancy Related

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During vital sign assessment of a pregnant patient in her third trimester, the patient complains of
feeling faint, dizzy, and agitated. Which nursing intervention is most appropriate?

  • A. Which nursing intervention is most appropriate?
  • B. Have the patient stand up and retake her blood pressur
  • C. Have the patient sit down and hold her arm in a dependent position.
  • D. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.
Correct Answer: D

Rationale: The correct answer is D: Have the patient turn to her left side and recheck her blood pressure in 5 minutes. This intervention is most appropriate because the patient is experiencing symptoms of potential hypotension, common in pregnant women due to changes in blood volume and hormonal levels. Turning the patient to her left side helps improve blood flow to the heart and can alleviate symptoms. Rechecking the blood pressure in 5 minutes allows for monitoring of any changes.

Choice A is incorrect as it does not provide a specific intervention. Choice B is incorrect as having the patient stand up may worsen symptoms. Choice C is incorrect as holding the arm in a dependent position may not effectively address the underlying issue of hypotension.

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A client in her third trimester reports increased perineal pressure. Which is the clinical cause for this complaint?

  • A. Fundal height
  • B. Urinary infection
  • C. Constipation
  • D. Hydramnios
Correct Answer: A

Rationale: The correct answer is A: Fundal height. In the third trimester, the growing uterus causes increased pressure on the pelvic organs, leading to perineal pressure. Fundal height measures the height of the uterus and correlates with gestational age, indicating the position and size of the fetus. As the uterus grows, fundal height increases, causing pressure on the perineal area. Urinary infection (B) can cause discomfort but would present with other symptoms like burning urination. Constipation (C) may cause discomfort but typically does not lead to increased perineal pressure. Hydramnios (D) refers to excess amniotic fluid, which can lead to abdominal distension but is not directly related to perineal pressure.

A patient in her first trimester complains of nausea and vomiting. She asks, 'Why does this happen?' The nurse's best response is:

  • A. It is due to an increase in gastric motility.'
  • B. It may be due to changes in hormones.'
  • C. It is related to an increase in glucose levels.'
  • D. It is caused by a decrease in gastric secretions.'
Correct Answer: B

Rationale: Nausea and vomiting are believed to be caused by increased levels of hormones, decreased gastric motility, and hypoglycemia.

Which comment made by a new mother to her own mother is most likely to encourage the grandmother's participation in the infant's care?

  • A. "Could you help me with the housework today?"
  • B. "The baby is spitting up a lot. What should I do?"
  • C. "I know you are busy, so I'll get John's mother to help me
  • D. “The baby has a stomachache. I’ll call the nurse to find out what to do.
Correct Answer: B

Rationale: The correct answer is B because it directly involves the grandmother in the baby's care by seeking advice and guidance. Asking for help with a specific issue shows trust and respect for the grandmother's experience. Choice A is about housework, not infant care. Choice C suggests seeking help elsewhere. Choice D involves a healthcare professional, not the grandmother.

What is the physiologic reason for vascular volume increasing by 40% to 60% during pregnancy?

  • A. Prevents maternal and fetal dehydration
  • B. Eliminates metabolic wastes of the mother
  • C. Provides adequate perfusion of the placenta
  • D. Compensates for decreased renal plasma flow
Correct Answer: C

Rationale: The correct answer is C: Provides adequate perfusion of the placenta. During pregnancy, the increased vascular volume ensures sufficient blood flow to the placenta, supplying oxygen and nutrients to the developing fetus. This is crucial for fetal growth and development. The other choices are incorrect because:
A: Preventing maternal and fetal dehydration is not the main reason for the significant increase in vascular volume during pregnancy.
B: Eliminating metabolic wastes of the mother does not require such a substantial increase in vascular volume.
D: Compensating for decreased renal plasma flow is not the primary physiologic reason for the vascular volume expansion during pregnancy.

Which of these findings would indicate a potential complication related to renal function during pregnancy?

  • A. Increase in glomerular filtration rate (GFR)
  • B. Increase in serum creatinine level
  • C. Decrease in blood urea nitrogen (BUN)
  • D. Mild proteinuria
Correct Answer: B

Rationale: Step-by-step rationale:
1. In a healthy pregnancy, GFR increases to accommodate the increased metabolic demands.
2. An increase in serum creatinine level indicates impaired renal function, as creatinine clearance decreases during pregnancy.
3. Decrease in BUN is normal due to increased GFR.
4. Mild proteinuria can be common in pregnancy without indicating a complication.
Therefore, an increase in serum creatinine level (Choice B) suggests a potential renal complication during pregnancy.

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