Anatomy and Physiology of Pregnancy

Anatomy and Physiology of Pregnancy Related

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To reassure and educate their pregnant patients about changes in their blood pressure, maternity nurses should be aware that:

  • A. a blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.
  • B. shifting the patient's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.
  • C. the systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant.
  • D. compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.
Correct Answer: C

Rationale: The correct answer is C because during pregnancy, the systolic blood pressure tends to increase slightly as pregnancy progresses due to increased cardiac output and decreased systemic vascular resistance. On the other hand, the diastolic pressure typically remains constant or may even decrease slightly. This physiological change is important for maternity nurses to be aware of in order to differentiate normal pregnancy-related changes from potential complications like preeclampsia.

Choices A, B, and D are incorrect:
A: This choice discusses the effect of cuff size on blood pressure readings, which is important but not directly related to the changes in blood pressure during pregnancy.
B: Shifting positions and changing arms for measurements may affect accuracy but is not specifically related to blood pressure changes during pregnancy.
D: Compression of iliac veins and inferior vena cava by the uterus leading to hemorrhoids is unrelated to changes in blood pressure during pregnancy.

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What is the term for the step in maternal role attainment that relates to the woman giving up certain aspects of her previous life?

  • A. Fantasy
  • B. Grief work
  • C. Role playing
  • D. Looking for a fit
Correct Answer: B

Rationale: The correct answer is B: Grief work. In the process of maternal role attainment, giving up certain aspects of her previous life involves experiencing grief over the losses associated with the new role. This step is essential for the woman to fully embrace her new identity as a mother. Fantasy (A) refers to imagining scenarios, role playing (C) involves acting out behaviors, and looking for a fit (D) focuses on finding a balance between personal needs and the demands of the maternal role. Grief work is the most appropriate term that specifically addresses the emotional process of letting go and adjusting to the new responsibilities of motherhood.

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.

Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth?

  • A. Epulis
  • B. Chloasma
  • C. Telangiectasia
  • D. Striae gravidarum
Correct Answer: D

Rationale: Striae gravidarum, or stretch marks, persist after pregnancy, although they may fade over time. Other changes like epulis and chloasma typically resolve postpartum.

A woman is in her seventh month of pregnancy. She has been reporting nasal congestion and occasional epistaxis. The nurse suspects that:

  • A. this is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
  • B. this is an abnormal cardiovascular change, and the nosebleeds are an ominous sign.
  • C. the woman is a victim of domestic violence and is being hit in the face by her partner.
  • D. the woman has been using cocaine intranasally.
Correct Answer: A

Rationale: Rationale:
A: Correct. Nasal congestion and epistaxis are common in pregnancy due to increased estrogen causing mucosal swelling and vasodilation.
B: Incorrect. Nosebleeds are not typically indicative of cardiovascular issues in pregnancy.
C: Incorrect. There is no evidence to suggest domestic violence based on the symptoms provided.
D: Incorrect. Cocaine use would have more severe implications beyond just nasal congestion and epistaxis in pregnancy.

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.

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