A pregnant woman has come to the emergency department with ...

[tuffie]

A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis. What is the correct interpretation of these symptoms by the practitioner?
 
  a. These conditions are abnormal. Refer the patient to an ear, nose, and throat
  specialist.
  b. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
  c. Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and
  epistaxis are within normal limits.
  d. Estrogen causes increased blood supply to the mucous membranes and can result
  in congestion and nosebleeds.

Question 2

The primiparous client has told the nurse that she is afraid she will develop hemorrhoids during pregnancy because her mother did. Which of the following statements would be best for the nurse to make?
 
  1. It is not unusual for women to develop hemorrhoids during pregnancy.
  2. Most women don't have any problem until after they've delivered.
  3. If your mother had hemorrhoids, you will get them too. Get used to the idea.
  4. If you get hemorrhoids, you probably will need surgery to get rid of them.

[Sierray]

Answer to Question 1

D
Feedback
A The patient should be reassured that these symptoms are within normal limits.
No referral is needed at this time.
B Progesterone is responsible for the heightened awareness of the need to breathe
in pregnancy. Progesterone levels increase during pregnancy.
C Progesterone affects relaxation of the smooth muscles in the respiratory tract.
D As capillaries become engorged, the upper respiratory tract is affected by the
subsequent edema and hyperemia, which causes these conditions, seen
commonly during pregnancy.

Answer to Question 2

1
Rationale:
1. Many pregnant women will develop hemorrhoids (anal varicose veins) either during pregnancy or after delivery from the pushing efforts of the second stage of labor. The increased weight of the gravid uterus, combined with constipation, can result in the varicosities' prolapsing.
2. Many pregnant women will develop hemorrhoids (anal varicose veins) either during pregnancy or after delivery from the pushing efforts of the second stage of labor.
3. Although there is a familial tendency to develop varicosities, including hemorrhoids, a family history does not automatically mean that a client will develop the condition.
4. Most hemorrhoids will resolve spontaneously, and will not require surgical intervention.

[tuffie]

TYSM

[amandanbreshears]

Excellent