A woman in her third trimester of pregnancy complains of a ...

[kamilo84]

A woman in her third trimester of pregnancy complains of a painful burning sensation in her hands and lower arms. Which action by the nurse is best?
 
  A.
  Advise the woman to elevate her hands at night.
  B.
  Document the finding and alert the provider.
  C.
  Encourage the woman to see a neurologist.
  D.
  Request a prescription for pregabalin (Lyrica).

Question 2

A woman in the emergency department is in her third trimester and is bleeding heavily from a laceration on her thigh from a car crash. She is pale and diaphoretic. Her blood pressure is 138/82 mm Hg. What can the nurse conclude from this information?
 
  A.
  Blood loss from the laceration has not been that great.
  B.
  She is in shock from the trauma of the injury and blood loss.
  C.
  Her increased blood volume is maintaining the blood pressure.
  D.
  Her vital signs and physical assessment do not match.

[BAOCHAU2803]

Answer to Question 1

ANS: A
Edema that occurs during pregnancy can lead to fluid collection in the wrist and puts pressure on the median nerve. This leads to carpal tunnel syndrome, characterized by burning pain and paresthesia in the (usually dominant) hand or hands up to the elbow. The nurse should advise the woman to elevate her hands at night. Carpal tunnel syndrome usually resolves after pregnancy, but if it persists, the woman may require surgical treatment. The nurse should always document abnormal findings and alert the provider, but further action is needed. Lyrica is used for nerve pain and would not be suggested here.

Answer to Question 2

ANS: C
Maternal blood volume increases by 40 to 50 near term. The nurse would expect the blood pressure to be low due to the blood loss, but the pregnancy-related extra volume is maintaining the blood pressure at normal levels. The vital signs and physical assessment do not match, but that is vague and does not explain the inconsistency. The patient is not in shock.

[kamilo84]

Excellent

[ryansturges]

TYSM