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 B
Explanation
Choice A rationale
Oligohydramnios refers to a condition where there is too little amniotic fluid. An amniotic fluid volume of 1900 mL is above the normal range, indicating that oligohydramnios is not present.
Choice B rationale
Polyhydramnios is the condition of having too much amniotic fluid. The normal range for amniotic fluid volume at 34 weeks gestation is between 800 and 1000 mL. An estimated volume of 1900 mL indicates polyhydramnios, which can be associated with various maternal and fetal conditions.
Choice C rationale
A follow-up glucose test is not directly indicated by the finding of polyhydramnios. While polyhydramnios can be associated with gestational diabetes, the decision to perform a glucose test would depend on other clinical factors and the patient’s history.
Choice D rationale
An amniotic fluid volume of 1900 mL is above the normal range for 34 weeks gestation, so it is not considered normal for gestational age. This finding indicates polyhydramnios rather than a normal fluid level.
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.