A nurse is teaching a client in her second trimester about measures to relieve heartburn during pregnancy.Which of the following measures does the nurse include in the teaching? (Select all that apply)
Lie down after meals.
Remain upright after meals.
Eat small, frequent meals.
Drink 2 large glasses of water before each meal.
Discuss antacid recommendations with the provider.
Correct Answer : B,C,E
Choice A rationale
Lying down after meals can exacerbate heartburn by allowing stomach acid to flow back into the esophagus. It is generally recommended to remain upright after eating to help prevent this.
Choice B rationale
Remaining upright after meals helps prevent heartburn by keeping stomach acid in the stomach and reducing the likelihood of acid reflux. This can be achieved by sitting or standing for at least 30 minutes after eating.
Choice C rationale
Eating small, frequent meals can help prevent heartburn by reducing the amount of food in the stomach at any one time, which decreases the pressure on the stomach and the likelihood of acid reflux.
Choice D rationale
Drinking large amounts of water before meals can increase the volume in the stomach and may exacerbate heartburn. It is generally better to drink fluids between meals rather than before or during meals.
Choice E rationale
Discussing antacid recommendations with the provider is appropriate. Antacids can help neutralize stomach acid and provide relief from heartburn, but it is important to consult with a healthcare provider to ensure that the chosen antacid is safe for use during pregnancy.
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Correct Answer is C
Explanation
Choice A rationale
Taking iron with milk is not recommended because calcium in milk can inhibit the absorption of iron. It is better to take iron supplements with a source of vitamin C, which enhances iron absorption.
Choice B rationale
Iron supplements typically cause constipation rather than loose stools. Common side effects include nausea, vomiting, and dark stools.
Choice C rationale
Taking iron with vitamin C enhances absorption. Vitamin C converts iron into a form that is more easily absorbed by the body, making it more effective in treating iron deficiency anemia.
Choice D rationale
Iron supplements are best absorbed on an empty stomach, but they can cause gastrointestinal discomfort. If this occurs, taking them with a small amount of food may help, but it should not be taken with dairy products or calcium-rich foods.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale
Nausea is a common symptom during pregnancy, especially in the first trimester. It is often referred to as morning sickness, although it can occur at any time of the day. The client’s report of nausea almost every day for the last two months, but lasting for a shorter period of the day, is consistent with typical pregnancy-related nausea.
Choice B rationale
Malodorous vaginal discharge is not a common or expected physiological change during pregnancy. It may indicate an infection or other medical condition that requires further evaluation and treatment.
Choice C rationale
Increased frequency of urination is a common symptom during pregnancy. It occurs due to hormonal changes and the growing uterus putting pressure on the bladder. The client’s report of voiding more frequently without pain is consistent with normal physiological changes during pregnancy.
Choice D rationale
Fundal height measurement is used to assess fetal growth and development. At 18 weeks of gestation, the fundal height is typically around 18 cm, which corresponds to the number of weeks of pregnancy. This finding is consistent with expected physiological changes during pregnancy.
Choice E rationale
The darkened line of skin noted midline on the abdomen, known as the linea nigra, is a common physiological change during pregnancy. It is caused by increased pigmentation and is a normal finding.
Choice F rationale
A dry, reddened patch of skin below the knee bilaterally is not a common or expected physiological change during pregnancy. It may indicate a dermatological condition or other medical issue that requires further evaluation.