A nurse is caring for a pregnant client who is experiencing increased urinary protein levels.

What is the primary cause of this change?

Increased glomerular filtration rate.

This is because during pregnancy, the renal blood flow and glomerular filtration rate increase to meet the increased metabolic demands of the mother and fetus.

This can result in increased urinary protein excretion, which is usually mild and does not indicate renal damage.

Choice A is wrong because decreased glomerular permeability would reduce the amount of protein that can pass through the glomerulus and into the urine.

Choice B is wrong because decreased protein intake would not affect the urinary protein levels, unless the intake is severely deficient.

Choice D is wrong because increased tubular reabsorption would decrease the amount of protein that is excreted in the urine, as the tubules would reabsorb more protein from the filtrate and return it to the blood.

Peristalsis and uterine contractility would increase.

This is because progesterone is a hormone that relaxes the smooth muscles of the uterus and the gastrointestinal tract during pregnancy.

If progesterone were reduced or withdrawn, the uterus would contract more and peristalsis would increase, leading to possible preterm labor and digestive problems.

Choice A is wrong because insulin resistance would be decreased, not increased, by lower progesterone levels.

Progesterone increases insulin resistance during pregnancy to ensure adequate glucose supply for the fetus.

Choice B is wrong because sweat and sebaceous glands would decrease production, not increase, by lower progesterone levels.

Progesterone stimulates the activity of these glands during pregnancy to regulate body temperature and protect the skin from infections.

Choice C is wrong because pyrosis (heartburn) would decrease in frequency, not increase, by lower progesterone levels.

Progesterone relaxes the lower esophageal sphincter during pregnancy, allowing gastric acid to reflux into the esophagus and cause pyrosis.