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 ["A","C","E","G"]
Explanation
Choice A rationale
Blood pressure is a critical parameter to monitor during pregnancy. Elevated blood pressure, as seen in this case (149/91 mmHg), can indicate the onset of hypertensive disorders such as preeclampsia, which can have severe consequences for both the mother and the fetus. Preeclampsia is characterized by high blood pressure and signs of damage to another organ system, often the kidneys. It is essential to report elevated blood pressure to the provider for further evaluation and management.
Choice B rationale
Gastrointestinal complaints, such as nausea and vomiting, are common during pregnancy due to hormonal changes. However, they are typically not a priority unless they are severe or accompanied by other concerning symptoms. In this case, the gastrointestinal complaints are mild and have been present for 2-3 weeks, which is consistent with normal early pregnancy symptoms.
Choice C rationale
Lower abdominal cramping can be a sign of various conditions, including normal uterine growth, gastrointestinal issues, or more serious concerns such as ectopic pregnancy or miscarriage. Given the patient’s report of vaginal spotting and mild abdominal cramping, it is crucial to report this to the provider to rule out any potential complications.
Choice D rationale
The hCG result is important for confirming pregnancy and monitoring its progression. However, in this context, it is not the most immediate priority compared to other symptoms. Elevated or abnormal hCG levels can indicate potential issues, but the presence of other symptoms such as spotting and cramping takes precedence.
Choice E rationale
Vaginal spotting during early pregnancy can be a sign of implantation bleeding, but it can also indicate more serious conditions such as threatened miscarriage or ectopic pregnancy. Given the patient’s report of spotting and cramping, it is essential to report this to the provider for further evaluation and management.
Choice F rationale
Heart rate is an important vital sign to monitor, but in this case, the patient’s heart rate is within the normal range for pregnancy. Therefore, it is not a priority to report unless there are other concerning symptoms or significant changes in heart rate.
Choice G rationale
Dysuria, or painful urination, can indicate a urinary tract infection (UTI), which is common during pregnancy and can lead to complications if left untreated. UTIs can cause discomfort and may lead to more serious infections such as pyelonephritis. It is important to report dysuria to the provider for appropriate testing and treatment.
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.