What is a key difference between physiological edema of pregnancy and pathological edema that might indicate preeclampsia?
Physiological edema always involves facial swelling
Pathological edema is typically localized to the ankles
Physiological edema usually resolves with rest and elevation, while pathological edema is sudden and generalized
Pathological edema only occurs in the first trimester
The Correct Answer is C
Edema in pregnancy can be physiological due to increased plasma volume, decreased colloid osmotic pressure, and uterine compression of venous return, or pathological, as in preeclampsia. Plasma volume expands 40–50% and colloid osmotic pressure decreases from ~25 mmHg to ~22 mmHg, favoring dependent edema in legs and ankles. Physiological edema is gradual, dependent, and improves with rest or leg elevation. Pathological edema in preeclampsia is sudden, generalized (including face and hands), and associated with hypertension (≥140/90 mmHg after 20 weeks) and proteinuria (>300 mg/24h).
Rationale for correct answers
3. Physiological edema is dependent and improves with rest/elevation, while pathological edema in preeclampsia is sudden, generalized, and often resistant to postural changes. Its association with hypertension and proteinuria makes it clinically significant.
Rationale for incorrect answers
1. Physiological edema typically affects ankles and feet, not the face. Facial swelling is more concerning for preeclampsia.
2. Pathological edema is not localized to the ankles; it is usually generalized, involving face, hands, and sometimes entire body.
4. Pathological edema of preeclampsia occurs after 20 weeks, not in the first trimester. Early pregnancy edema is usually benign and physiologic.
Take home points
- Physiological edema is dependent, gradual, and resolves with rest and elevation.
- Pathological edema in preeclampsia is sudden, generalized, and associated with hypertension and proteinuria.
- Facial and hand swelling are red flags for preeclampsia.
- Differentiation is critical, as preeclampsia increases risk of maternal and fetal complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Braxton Hicks contractionsare irregular uterine contractions, generally painless, that do not cause cervical change. They begin as early as the second trimester but are most noticeable in the third trimester. Uterine tone normally increases with pregnancy due to rising estrogen and oxytocin receptor sensitivity, but Braxton Hicks contractions remain non-progressive. They are sometimes referred to as “false labor” because, unlike true labor contractions, they do not lead to cervical effacement or dilation.
Rationale for correct answers
2.Irregular, often painless uterine contractions without cervical dilation or effacement are the hallmark of Braxton Hicks. They usually resolve with rest, hydration, or position change and are not considered true labor.
Rationale for incorrect answers
1.Regular, painful contractions that cause cervical dilation define true labor, not Braxton Hicks. True labor contractions progressively intensify and shorten in interval.
3.Braxton Hicks contractions improve, not worsen, with hydration and rest. Worsening with activity and persistence despite rest indicates true labor.
4.Braxton Hicks are not a sign of true labor. They are preparatory contractions and do not indicate imminent delivery.
Take home points
- Braxton Hicks contractions are irregular, mild, and non-progressive.
- They do not cause cervical dilation or effacement.
- True labor is characterized by regular, painful contractions with progressive cervical change.
- Hydration, rest, or position change relieves Braxton Hicks but not true labor.
Correct Answer is ["A","B","D"]
Explanation
Constipation in pregnancyis due to progesterone-induced smooth muscle relaxation, reduced gastrointestinal motility, and increased water absorptionin the colon. Normal bowel frequency is 3 times per day to 3 times per week, with stool water content 70–75%. Constipation is worsened by iron supplements, low fiber intake (normal recommended 25–30 g/day), and dehydration (recommended fluid intake 2–3 L/day). Nursing assessment should focus on bowel habits, diet, and hydration status.
Rationale for correct answers
1.Evaluating bowel frequency and consistency identifies deviations from normal patterns and confirms constipation. Hard, infrequent stools suggest delayed colonic transit.
2.Assessing dietary fiber intake is essential since insufficient fiber reduces stool bulk and increases constipation risk. Recommended intake is 25–30 g/day.
4.Checking hydration status is important because inadequate fluid intake leads to excessive colonic water reabsorption, hardening stools. Adequate hydration softens stool and improves motility.
Rationale for incorrect answers
3.Monitoring respiratory rate is not relevant to constipation assessment. Respiratory changes in pregnancy are related to diaphragm elevation, not bowel habits.
5.Measuring blood glucose levels is related to screening for gestational diabetes, not constipation. Constipation is unrelated to glycemic status.
Take home points
- Constipation in pregnancy is due to progesterone, iron supplements, low fiber, and dehydration.
- Assessment should focus on stool frequency/consistency, fiber intake, and hydration status.
- Adequate hydration (2–3 L/day) and fiber (25–30 g/day) prevent constipation.
- Must differentiate constipation from bowel obstruction, which presents with pain, distension, and vomiting.
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