A woman in her 26th week of pregnancy states that she is not ...

[crobinson2013]

A woman in her 26th week of pregnancy states that she is not really short of breath but feels that she is aware of her breathing and the need to breathe. What is the nurse's best reply?
 
  a. The diaphragm becomes fixed during pregnancy, making it difficult to take in a deep breath.
  b. The increase in estrogen levels during pregnancy often causes a decrease in the diameter of the rib cage and makes it difficult to breathe.
  c. What you are experiencing is normal. Some women may interpret this as shortness of breath, but it is a normal finding and nothing is wrong.
  d. This increased awareness of the need to breathe is normal as the fetus grows because of the increased oxygen demand on the mother's body, which results in an increased respiratory rate.

Question 2

The nurse is assessing the lungs of an older adult. Which of these changes are normal in the respiratory system of the older adult?
 
  a. Severe dyspnea is experienced on exertion, resulting from changes in the lungs.
  b. Respiratory muscle strength increases to compensate for a decreased vital capacity.
  c. Decrease in small airway closure occurs, leading to problems with atelectasis.
  d. Lungs are less elastic and distensible, which decreases their ability to collapse and recoil.

[cassie_ragen]

Answer to Question 1

ANS: C
During pregnancy, the woman may develop an increased awareness of the need to breathe. Some women may interpret this as dyspnea, although structurally nothing is wrong. Increases in estrogen relax the chest cage ligaments, causing an increase in the transverse diameter. Although the growing fetus increases the oxygen demand on the mother's body, this increased demand is easily met by the increasing tidal volume (deeper breathing). Little change occurs in the respiratory rate.

Answer to Question 2

ANS: D
In the aging adult, the lungs are less elastic and distensible, which decreases their ability to collapse and recoil. Vital capacity is decreased, and a loss of intra-alveolar septa occurs, causing less surface area for gas exchange. The lung bases become less ventilated, and the older person is at risk for dyspnea with exertion beyond his or her usual workload.