On her first visit, a patient had a baseline hemoglobin of 13.0 gm and a hematocrit of 42.9%.She has been taking ferrous sulfate tablets and eating an iron-rich diet.She returned to the clinic at 30 weeks gestation and has a hemoglobin of 11.0 gm and a hematocrit of 36.3%.She is concerned and confused about why these lab values have gone down.
In responding, which physiological change during pregnancy should the nurse describe to the patient?

The correct answer is choice D. Encourage the client to drink cold, carbonated fluids throughout the day.This helps to relieve the shoulder pain caused by the carbon dioxide gas used to inflate the abdomen during laparoscopy.

The gas irritates the diaphragm, which refers pain to the shoulder.Drinking cold, carbonated fluids can help expel the gas and reduce the pain.

Choice A is wrong because an abdominal binder is not necessary for a laparoscopic procedure.It is more commonly used for abdominal surgeries that involve a large incision.

Choice B is wrong because a rocking chair is not helpful for a client who had a laparoscopic BTL.It is more useful for a client who had a vaginal delivery to promote comfort and uterine involution.

Choice C is wrong because keeping the head of the bed flat for six hours is not indicated for a laparoscopic BTL.It may increase the risk of venous thromboembolism and pulmonary embolism due to prolonged immobility.The client should be encouraged to ambulate as soon as possible after surgery.

The correct answer is choice D. Leaning slightly backwards when walking can increase the curvature of the lower spine and worsen back pain.

The other choices are helpful methods to alleviate back pain during pregnancy.

Choice A is correct because pelvic tilt exercises can strengthen the abdominal muscles and reduce the strain on the lower back.

Choice B is correct because wearing shoes with low heels can improve posture and balance and prevent excessive arching of the lower back.

Choice C is correct because sleeping on the side with a pillow beneath the knees can support the spine and pelvis and relieve pressure on the lower back.

Normal ranges for back pain during pregnancy vary depending on the individual, but some common factors that can affect it are weight gain, hormonal changes, center of gravity shift, stress and muscle separation.