A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman: (Select the one most appropriate answer.

Eat five small meals daily.

Lie down after each meal.

Reduce the amount of fiber she consumes.

Substitute other calcium sources for milk in her diet.

Answer and Explanation

The Correct Answer is A

Choice A reason: Eating five small meals daily can help reduce heartburn in pregnancy by preventing overeating and reducing the pressure on the stomach from the growing uterus. It can also help maintain a steady blood glucose level and prevent nausea and vomiting.

Choice B reason: Lying down after each meal can worsen heartburn in pregnancy by allowing the stomach acid to reflux into the esophagus. It can also cause breathing difficulties and increase the risk of aspiration. The woman should avoid lying down for at least two hours after eating and elevate her head and chest when sleeping.

Choice C reason: Reducing the amount of fiber she consumes can cause constipation and hemorrhoids in pregnancy, which can increase the discomfort and pain. Fiber is important for maintaining a healthy digestive system and preventing gestational diabetes and preeclampsia. The woman should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, beans, and nuts.

Choice D reason: Substituting other calcium sources for milk in her diet can deprive the woman and the baby of essential nutrients, such as protein, vitamin D, and riboflavin. Milk is not a common cause of heartburn in pregnancy, unless the woman is lactose intolerant or allergic to dairy products. The woman should consume at least three servings of dairy products per day or take calcium supplements as prescribed.

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Correct Answer is B

Explanation

Choice A reason: An antiemetic such as pyridoxine may be used to control vomiting in women with hyperemesis gravidarum, but it is not the initial treatment. The first priority is to restore fluid and electrolyte balance and prevent dehydration and hypovolemia.

Choice B reason: IV therapy is the initial treatment for women with hyperemesis gravidarum. It helps to correct fluid and electrolyte imbalances, prevent dehydration and hypovolemia, and restore normal blood pressure and urine output. IV fluids may also contain glucose, vitamins, and electrolytes to replenish losses.

Choice C reason: Enteral nutrition may be used to meet nutritional needs in women with hyperemesis gravidarum, but it is not the initial treatment. Enteral nutrition involves feeding through a tube inserted into the stomach or intestine. It may be considered if oral intake is not tolerated or adequate after IV therapy.

Choice D reason: Corticosteroids are not used to treat hyperemesis gravidarum. They are used to reduce inflammation in conditions such as asthma, rheumatoid arthritis, and allergic reactions. They have no effect on nausea and vomiting in pregnancy.

A. compensate for decreased renal plasma flow. B. prevent maternal and fetal dehydration. C. provide adequate perfusion of the placenta. D. eliminate metabolic wastes of the mother.

Correct Answer is C

Explanation

Choice A reason: Vascular volume increases during pregnancy to meet the increased oxygen and nutrient demands of the fetus, not to compensate for decreased renal plasma flow. In fact, renal plasma flow increases by 50% to 80% during pregnancy to facilitate the excretion of metabolic wastes.

Choice B reason: Vascular volume increases during pregnancy to ensure adequate blood supply to the uterus and other organs, not to prevent maternal and fetal dehydration. Dehydration can occur due to vomiting, diarrhea, or inadequate fluid intake, and it can be prevented by drinking enough fluids and replacing electrolytes.

Choice C reason: Vascular volume increases during pregnancy to provide adequate perfusion of the placenta, which is the main organ of gas exchange and nutrient delivery for the fetus. The placenta receives about 10% of the maternal cardiac output at term.

Choice D reason: Vascular volume increases during pregnancy to support the growth and development of the fetus and the maternal tissues, not to eliminate metabolic wastes of the mother. Metabolic wastes are eliminated by the kidneys, lungs, skin, and gastrointestinal tract.

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A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman: (Select the one most appropriate answer.

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Naxlex Comprehensive Predictor Exams

The nurse caring for a woman hospitalized for hyperemesis gravidarum should expect that initial treatment will involve:

Correct Answer is B

Explanation

The maternity nurse understands that vascular volume increases 40% to 45% during pregnancy to:

Correct Answer is C

Explanation

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