The nurse auscultates a functional systolic murmur, grade II/IV, ...

[clmills979]

The nurse auscultates a functional systolic murmur, grade II/IV, on a woman in week 30 of her pregnancy. The remainder of her physical assessment is within normal limits. The nurse would:
 
  a. Consider this finding abnormal, and refer her for additional consultation.
  b. Ask the woman to run briefly in place and then assess for an increase in intensity of the murmur.
  c. Know that this finding is normal and is a result of the increase in blood volume during pregnancy.
  d. Ask the woman to restrict her activities and return to the clinic in 1 week for re-evaluation.

Question 2

A woman in her second trimester of pregnancy complains of heartburn and indigestion. When discussing this with the woman, the nurse considers which explanation for these problems?
 
  a. Tone and motility of the gastrointestinal tract increase during the second trimester.
  b. Sluggish emptying of the gallbladder, resulting from the effects of progesterone, often causes heartburn.
  c. Lower blood pressure at this time decreases blood flow to the stomach and gastrointestinal tract.
  d. Enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.

[xiaomengxian]

Answer to Question 1

ANS: C
Because of the increase in blood volume, a functional systolic murmur, grade II/IV or less, can be heard in 95 of pregnant women. The other actions are not appropriate.

Answer to Question 2

ANS: D
Stomach displacement from the enlarging uterus plus altered esophageal sphincter and gastric tone as a result of progesterone predispose the woman to heartburn. The tone and motility of the gastrointestinal tract are decreased, not increased, during pregnancy. Emptying of the gallbladder may become more sluggish during pregnancy but is not related to indigestion. Rather, some women are predisposed to gallstone formation. A lower blood pressure may occur during the second semester, but it does not affect digestion.

[clmills979]

TYSM

[essyface1]

Excellent