A 26-year-old woman at 29 weeks' gestation experienced epigastric ...

[stephzh]

A 26-year-old woman at 29 weeks' gestation experienced epigastric pain following the consumption of a large meal of fried fish and onion rings. The pain resolved a few hours later. The most likely diagnosis for this symptom is:
 
  a. Cholelithiasis
  b. Influenza
  c. Urinary tract infection
  d. Indigestion

Question 2

A woman presents to the prenatal clinic at 30 weeks' gestation reporting dysuria, frequency, and urgency with urination. Appropriate nursing actions include:
 
  a. Obtain clean-catch urine to assess for a possible urinary tract infection.b. Reassure the woman that the signs are normal urinary changes in the third trimester.c. Teach the woman to decrease fluid intake to manage these symptoms.d. Perform a Leopold's maneuver to assess fetal position and station.

[lkoler]

Answer to Question 1

ANS: a
Feedback
a. The progesterone-induced prolonged emptying time of bile from the gallbladder, combined with elevated blood cholesterol levels, may predispose the pregnant woman to gallstone formation (cholelithiasis). Pain in the epigastric region following ingestion of a high-fat meal constitutes the major symptom of these conditions. The pain is self-limiting and usually resolves within 2 hours.
b. The symptoms described are not associated with influenza.
c. The symptoms described are not associated with urinary tract infection.
d. Prolonged emptying time of bile from the gallbladder, combined with elevated blood cholesterol levels, make cholelithiasis a more probable diagnosis than indigestion.

Answer to Question 2

ANS: a
Feedback
a. Correct. Dysuria, frequency, and urgency with urination are signs and symptoms of a urinary tract infection, necessitating further assessment and testing.
b. These are abnormal urinary symptoms in the third trimester.
c. Pregnant women need to increase their fluid intake during pregnancy, and dysuria and urgency are abnormal.
d. Assessment of fetal position and station is not an appropriate response to reported signs and symptoms of a urinary tract infection.

[stephzh]

Excellent

[tanna.moeller]

TYSM