A nurse is answering Questions about labor and delivery to a client.The client is concerned that she will need a blood transfusion due to all the blood loss during the delivery.The nurse explains that blood volume increases during pregnancy that will offset the loss.Which of the following is the correct percentage of increased blood volume during pregnancy that the nurse should explain to the client?
25%-35%.
10%-20%.
60%-70%.
40%-50%.
The Correct Answer is D
Choice A rationale
A 25%-35% increase in blood volume is lower than the actual increase observed during pregnancy. This choice is incorrect.
Choice B rationale
A 10%-20% increase in blood volume is significantly lower than the actual increase observed during pregnancy. This choice is incorrect.
Choice C rationale
A 60%-70% increase in blood volume is higher than the actual increase observed during pregnancy. This choice is incorrect.
Choice D rationale
The correct percentage of increased blood volume during pregnancy is 40%-50%. This increase helps accommodate the growing fetus and placenta, and prepares the body for the blood loss that occurs during delivery.
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Correct Answer is ["A","C","E"]
Explanation
Choice A rationale
Blood pressure is a critical parameter to monitor during pregnancy. Elevated blood pressure, as seen in this case (149/91 mmHg), can indicate the onset of hypertensive disorders such as preeclampsia, which can have severe consequences for both the mother and the fetus. Preeclampsia is characterized by high blood pressure and signs of damage to another organ system, often the kidneys. It is essential to report elevated blood pressure to the provider for further evaluation and management.
Choice B rationale
Gastrointestinal complaints, such as nausea and vomiting, are common during pregnancy due to hormonal changes. However, they are typically not a priority unless they are severe or accompanied by other concerning symptoms. In this case, the gastrointestinal complaints are mild and have been present for 2-3 weeks, which is consistent with normal early pregnancy symptoms.
Choice C rationale
Lower abdominal cramping can be a sign of various conditions, including normal uterine growth, gastrointestinal issues, or more serious concerns such as ectopic pregnancy or miscarriage. Given the patient’s report of vaginal spotting and mild abdominal cramping, it is crucial to report this to the provider to rule out any potential complications.
Choice D rationale
The hCG result is important for confirming pregnancy and monitoring its progression. However, in this context, it is not the most immediate priority compared to other symptoms. Elevated or abnormal hCG levels can indicate potential issues, but the presence of other symptoms such as spotting and cramping takes precedence.
Choice E rationale
Vaginal spotting during early pregnancy can be a sign of implantation bleeding, but it can also indicate more serious conditions such as threatened miscarriage or ectopic pregnancy. Given the patient’s report of spotting and cramping, it is essential to report this to the provider for further evaluation and management.
Choice F rationale
Heart rate is an important vital sign to monitor, but in this case, the patient’s heart rate is within the normal range for pregnancy. Therefore, it is not a priority to report unless there are other concerning symptoms or significant changes in heart rate.
Choice G rationale
Dysuria, or painful urination, can indicate a urinary tract infection (UTI), which is common during pregnancy and can lead to complications if left untreated. UTIs can cause discomfort and may lead to more serious infections such as pyelonephritis. It is important to report dysuria to the provider for appropriate testing and treatment.
Correct Answer is B
Explanation
Choice A rationale
Adrenocorticotropic hormone (ACTH) is produced by the pituitary gland and stimulates the adrenal glands to release cortisol. It is not involved in the maturation of ovarian follicles.
Choice B rationale
Follicle-stimulating hormone (FSH) is produced by the pituitary gland and stimulates the growth and maturation of ovarian follicles. It is the correct hormone involved in the follicular phase of the ovarian cycle.
Choice C rationale
Oxytocin is a hormone involved in childbirth and lactation. It stimulates uterine contractions and milk ejection but is not involved in the maturation of ovarian follicles.
Choice D rationale
Luteinizing hormone (LH) is produced by the pituitary gland and triggers ovulation and the formation of the corpus luteum. It is not involved in the maturation of ovarian follicles during the follicular phase.
Choice E rationale
Prolactin is a hormone that stimulates milk production in the mammary glands. It is not involved in the maturation of ovarian follicles.
Choice F rationale
Progesterone is a hormone produced by the corpus luteum and the placenta during pregnancy. It prepares the endometrium for implantation and maintains pregnancy but is not involved in the maturation of ovarian follicles.