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 B
Explanation
Choice A rationale
Lisinopril is not a beta blocker; it is an ACE inhibitor. Beta blockers, such as metoprolol, are generally considered safer during pregnancy compared to ACE inhibitors. Beta blockers work by blocking the effects of adrenaline on your heart and blood vessels, which helps to lower blood pressure. However, they are not without risks and should be used under medical supervision during pregnancy.
Choice B rationale
Lisinopril is an ACE inhibitor, which is contraindicated during pregnancy, especially in the second and third trimesters. ACE inhibitors can cause fetal renal dysfunction, oligohydramnios, and even fetal death. Therefore, it is essential to discuss alternative medications that are safer during pregnancy.
Choice C rationale
This statement is incorrect because ACE inhibitors, including lisinopril, are not safe to continue during pregnancy. They pose significant risks to the fetus, particularly in the later stages of pregnancy.
Choice D rationale
Lisinopril is not an angiotensin II receptor blocker (ARB); it is an ACE inhibitor. ARBs, like ACE inhibitors, are also contraindicated during pregnancy due to similar risks of fetal toxicity and adverse outcomes.
Correct Answer is A
Explanation
Choice A rationale
The uterus can indeed increase in size by 20 times its non-pregnant size. This significant expansion is necessary to accommodate the growing fetus and the increased blood supply required during pregnancy.
Choice B rationale
While the weight of the uterus does increase significantly during pregnancy, from about 100 grams to approximately 1,000 grams, this statement does not directly address the client’s concern about the uterus’s ability to stretch.
Choice C rationale
About 25% of the increased capacity of the uterus is related to uteroplacental content, but this does not fully explain the uterus’s ability to stretch to accommodate a full-term baby.
Choice D rationale
The increase in uterus size during pregnancy is not solely related to amniotic fluid volume. The uterus itself grows and stretches significantly to accommodate the developing fetus.