Cardiovascular system changes occur during pregnancy. Which of ...

[EY67]

Cardiovascular system changes occur during pregnancy. Which of the following findings would be considered normal for a woman in her second trimester?
 
  1. Heart sounds (S1, S2) less audible
  2. Increase in pulse rate
  3. Increase in blood pressure
  4. Decrease in red blood cell production

Question 2

Screening at 24 weeks reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected out-come is to prevent injury to the fetus as a result of GDM.
 
  The nurse identifies that the fetus is at greatest risk for: 1. macrosomia.
  2. congenital anomalies of the central nervous system.
  3. preterm birth.
  4. low birth weight.

[perkiness]

Answer to Question 1

2
1. Incorrect. There is a more audible splitting of S1 and S2.
2. Correct. Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/minute, which then persists to term.
3. Incorrect. In the first trimester, blood pressure usually remains the same as the prepreg-nancy level, but then gradually decreases up to about 20 weeks of gestation. During the second trimester, both systolic and diastolic pressures decrease by about 5 to 10 mm Hg.
4. Incorrect. During pregnancy, there is an accelerated production of RBCs.

Answer to Question 2

1
1. Correct. Poor glycemic control later in pregnancy increases the rate of fetal macrosomia.
2. Incorrect. Poor glycemic control during the preconception time frame and into the early weeks of the pregnancy is associated with congenital anomalies.
3. Incorrect. Preterm labor or birth is more likely to occur with severe diabetes and is the greatest risk in women with pregestational diabetes.
4. Incorrect. Increased weight or macrosomia is the greatest risk factor for the fetus.

[EY67]

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