The maternity nurse understands that vascular volume increases 40% to 45% during pregnancy to:

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.

Choice A reason: Women without pain and who do not want to become pregnant need no treatment, as endometriosis is a benign condition that does not affect the general health or well-being of the woman. The nurse should explain to the client that endometriosis is a chronic condition that causes the growth of endometrial tissue outside the uterus, and that it can cause symptoms such as pelvic pain, dysmenorrhea, dyspareunia, and infertility. However, if the woman is asymptomatic and has no desire for pregnancy, she can choose to monitor the condition without any intervention.

Choice B reason: Surgical intervention often is needed for severe or acute symptoms, as endometriosis can cause complications such as adhesions, cysts, inflammation, or obstruction of the pelvic organs. The nurse should inform the client that surgery can be performed to remove or destroy the endometrial implants, or to perform a hysterectomy or oophorectomy in severe cases. The nurse should also discuss the benefits and risks of surgery, and the possibility of recurrence or persistence of symptoms.

Choice C reason: Side effects from the steroid danazol include masculinizing traits, as danazol is a synthetic androgen that suppresses the ovarian function and reduces the production of estrogen and progesterone. The nurse should warn the client that danazol can cause adverse effects such as acne, hirsutism, weight gain, voice changes, decreased breast size, and menstrual irregularities. The nurse should also advise the client to use a non-hormonal contraceptive method while taking danazol, as it can harm the fetus if pregnancy occurs.

Choice D reason: Bone loss from hypoestrogenism is not irreversible, as it can be prevented or treated with calcium and vitamin D supplements, bisphosphonates, or hormone replacement therapy. The nurse should educate the client that hypoestrogenism is a condition where the estrogen levels are abnormally low, and that it can occur as a result of some medications or surgical procedures for endometriosis. The nurse should also explain that hypoestrogenism can increase the risk of osteoporosis, which is a condition where the bones become weak and brittle.

Choice E reason: Women with mild pain who may want a future pregnancy may take nonsteroidal anti-inflammatory drugs (NSAIDs), as NSAIDs can reduce the inflammation and pain caused by endometriosis. The nurse should recommend the client to take NSAIDs as needed, and to follow the dosage and instructions on the label. The nurse should also inform the client that NSAIDs are not effective in treating the underlying cause of endometriosis, and that they may have side effects such as gastrointestinal irritation, bleeding, or ulcers.