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 C
Explanation
Choice A rationale
Providing additional information about the disorder is appropriate as it helps the couple understand the condition better and prepare for the future. This information can include the nature of the disorder, potential complications, and available treatments or interventions.
Choice B rationale
Referring the couple to a disorder-specific support group is also appropriate. Support groups can provide emotional support, practical advice, and a sense of community for families facing similar challenges. This can help the couple cope with the diagnosis and connect with others who have similar experiences.
Choice C rationale
Determining whether termination has been considered is inappropriate because the couple has already decided to continue the pregnancy. Bringing up termination at this point can be distressing and may undermine their decision. The nurse should respect their choice and focus on providing support and information relevant to continuing the pregnancy.
Choice D rationale
Explaining that they may experience grief, which is normal, is appropriate. Grief is a common response to learning about a serious genetic disorder in a fetus, and normalizing these feelings can help the couple process their emotions and seek appropriate support.