A patient in her third trimester of pregnancy complains of ...

[daltonest1984]

A patient in her third trimester of pregnancy complains of dizziness and faintness when she lies on her back. Which statement by the nurse is most appropriate?
 
  a. Don't worry, you don't have long to go until delivery.
  b. To improve the symptoms, lie on your left side instead of your back.
  c. The symptoms are due to an increase in cardiac output when you lie down.
  d. You will sleep more comfortably in a recliner.

Question 2

A pregnant woman diagnosed with anemia says, I don't see how I could be anemic. I have been very careful to take iron tablets and to eat a balanced diet. The nurse's most appropriate response is:
 
  a. Have you had any bleeding that might have caused this?
  b. It is normal to be anemic during pregnancy, so don't worry about it.
  c. During pregnancy, the fluid portion of your blood increases, which dilutes your red blood cells.
  d. You need additional red blood cells to supply your baby's oxygen needs. Too many of your blood cells are going to your baby.

[scrocafella]

Answer to Question 1

ANS: B
Supine hypotensive syndrome is a drop in cardiac output that may occur in the third trimester as a result of pressure on the inferior vena cava by the enlarged uterus. Cardiac output is best when lying on the left side.

Answer to Question 2

ANS: C
Both plasma and red blood cells (RBCs) increase during pregnancy, but the increase in plasma exceeds the increase in RBCs. This essentially dilutes the RBCs so that the patient's hemoglobin and hematocrit fall. The patient's hemoglobin and hematocrit should be measured routinely. A hemoglobin below 11 g/dL or a hematocrit below 35 merits evaluation for anemia.

[daltonest1984]

TYSM

[bitingbit]

Excellent