A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?

Choice A reason: This is incorrect because venipuncture for blood work should be avoided on the affected arm. The mastectomy may have involved the removal of lymph nodes, which can impair the lymphatic drainage and increase the risk of lymphedema (swelling) in the arm. Venipuncture can cause further damage or infection to the arm.

Choice B reason: This is correct because the BP cuff should not be applied to the affected arm. The BP cuff can exert pressure on the arm and interfere with the blood and lymph flow. This can also increase the risk of lymphedema or pain in the arm.

Choice C reason: This is incorrect because the affected arm should not be held down close to the woman's side. The woman should be encouraged to elevate the arm above the level of the heart and perform gentle exercises to promote circulation and prevent stiffness. The arm should not be immobilized or restricted.

Choice D reason: This is incorrect because the affected arm should not be used for IV therapy. IV therapy can introduce fluids or medications into the arm that can affect the blood and lymph flow. It can also cause irritation or infection to the arm.

The correct answer is A. You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month.

Choice A reason: This is the best advice for the woman, as it acknowledges that jogging is safe and beneficial in early pregnancy, but also informs her that she may need to adjust her exercise intensity and duration as her pregnancy progresses. Walking is a low-impact aerobic activity that can be done throughout pregnancy, as long as there are no complications or contraindications. Walking can help maintain cardiovascular fitness, prevent excessive weight gain, and reduce the risk of gestational diabetes and preeclampsia.

Choice B reason: This is not a good advice for the woman, as it implies that jogging is harmful for her joints and that she should stop it immediately. Jogging is not necessarily bad for the joints, as long as the woman wears appropriate shoes, avoids uneven surfaces, and listens to her body. Jogging can also provide many health benefits for the woman and the fetus, such as improved mood, increased energy, and reduced stress².

Choice C reason: This is a false and alarming statement that may discourage the woman from exercising at all. Exercise during pregnancy is not dangerous for the fetus, unless there are specific medical conditions or complications that prevent it. Exercise during pregnancy can actually improve the fetal growth, development, and oxygenation, as well as reduce the risk of preterm birth and low birth weight.

Choice D reason: This is an unrealistic and misleading statement that may cause the woman to overexert herself or ignore the signs of discomfort or fatigue. Exercise during pregnancy may need to be modified according to the woman's changing needs, abilities, and preferences. Some factors that may affect the type, frequency, intensity, and duration of exercise during pregnancy include the trimester, the fetal position, the maternal weight, the environmental temperature, and the presence of any symptoms or complications.