A nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy.Which of the following client statements indicates understanding of the teaching?
“If I develop striae gravidarum, I need to call my provider immediately.”.
“My nipples and areola will become pale as my breasts enlarge.”.
“I should begin to recognize fetal movement by 10 weeks gestation.”.
“Some nausea and vomiting is normal, but I should call my provider if I am unable to keep food or water down.”.
The Correct Answer is D
Choice A rationale
Striae gravidarum, or stretch marks, are a common occurrence during pregnancy due to the rapid stretching of the skin. They are not a medical emergency and do not require immediate attention from a healthcare provider.
Choice B rationale
During pregnancy, the nipples and areola typically become darker, not paler, as the breasts enlarge. This change is due to hormonal influences and increased blood flow to the area.
Choice C rationale
Fetal movement, also known as quickening, is usually felt by the mother between 18 to 25 weeks of gestation, not as early as 10 weeks. At 10 weeks, the fetus is still too small for its movements to be felt by the mother.
Choice D rationale
Some nausea and vomiting, known as morning sickness, is normal during pregnancy. However, if a pregnant woman is unable to keep food or water down, it is important to contact a healthcare provider to ensure she and the baby are receiving adequate nutrition and hydration.
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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.