A nurse is caring for a pregnant client who is experiencing increased urinary protein levels.
What is the primary cause of this change?
Decreased glomerular permeability.
Decreased protein intake.
Increased glomerular filtration rate.
Increased tubular reabsorption.
The Correct Answer is C
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.
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Correct Answer is D
Explanation
This is because a pregnant client may experience frequent urination at night due to increased urinary output caused by the increased blood volume and renal function during pregnancy.
This symptom is more common in the first and third trimesters.
Choice A is wrong because increased glomerular permeability does not cause nocturia, but it may cause proteinuria, which is the presence of protein in the urine.
Choice B is wrong because decreased renal blood flow does not cause nocturia, but it may cause renal ischemia, which is a condition where the kidneys do not receive enough blood supply.
Choice C is wrong because increased tubular reabsorption does not cause nocturia, but it may cause water retention and edema, which are swelling of the body tissues due to fluid accumulation.
Correct Answer is B
Explanation
This change alters the center of gravity and posture of the body because the uterus expands and shifts higher as the fetus grows during pregnancy.
This causes an increased strain on the muscles and ligaments supporting the vertebral column and leads to lower back pain.
Choice A is wrong because increased joint laxity does not alter the center of gravity and posture of the body.
It is caused by hormonal changes that loosen the ligaments throughout the body, resulting in decreased stability of the joints.
Choice C is wrong because increased muscle strain does not alter the center of gravity and posture of the body.
It is a consequence of the shift in the center of gravity and the weight gain during pregnancy, which put more pressure on the back muscles.
Choice D is wrong because decreased muscle strength does not alter the center of gravity and posture of the body.
It is not a common musculoskeletal change during pregnancy, although some women may experience fatigue or weakness due to hormonal changes or anemia.
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