What is the best nursing intervention for a pregnant woman in her third trimester who complains of feeling faint, dizzy, and agitated while her vital signs are being assessed?

Have the patient stand up and retake her blood pressure.

Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms.

Have the patient sit down and hold her arm in a dependent position.

Have the patient turn to her left side and recheck her blood pressure in 5 minutes.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not a good intervention, as it may worsen the symptoms of faintness, dizziness, and agitation. Standing up can cause a sudden drop in blood pressure (orthostatic hypotension), which can reduce the blood flow to the brain and the fetus. This can cause lightheadedness, blurred vision, and loss of consciousness in the woman, as well as fetal distress or hypoxia.

Choice B reason: This is not a good intervention, as it may also worsen the symptoms of faintness, dizziness, and agitation. Lying supine can cause compression of the inferior vena cava (a large vein that returns blood to the heart) by the gravid uterus, which can reduce the cardiac output (the amount of blood pumped by the heart) and the blood pressure. This can cause nausea, sweating, and visual disturbances in the woman, as well as fetal distress or hypoxia.

Choice C reason: This is not a good intervention, as it may not improve the symptoms of faintness, dizziness, and agitation. Sitting down and holding the arm in a dependent position can lower the blood pressure in the arm, but not in the rest of the body. This can cause inaccurate readings of the blood pressure and delay the detection of hypotension or hypertension. This can also cause discomfort and pain in the arm due to impaired circulation.

Choice D reason: This is the best intervention, as it can relieve the symptoms of faintness, dizziness, and agitation by improving the blood flow to the brain and the fetus. Turning to the left side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output and the blood pressure. This can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Limiting fluid intake throughout the day is not recommended, as dehydration can worsen nausea and vomiting. Instead, pregnant women should sip fluids gradually throughout the day to maintain hydration. Proper hydration supports digestion and helps prevent complications like electrolyte imbalances. Clinical guidelines emphasize the importance of maintaining adequate fluid intake during pregnancy

Choice B reason: Drinking a glass of water with a fat-free carbohydrate before getting out of bed in the morning is a good strategy to prevent nausea and vomiting, as it can stabilize the blood sugar level and prevent an empty stomach. However, it is not the best answer, as it does not address the dietary needs throughout the day.

Choice C reason: Increasing the intake of high-fat foods is not recommended, as it can worsen nausea and vomiting. High-fat foods are harder to digest and can cause gastric irritation and reflux. The pregnant woman should choose low-fat, bland, and easy-to-digest foods.

Choice D reason: Eating small, frequent meals every 2 to 3 hours is the best approach to managing nausea and vomiting during pregnancy. This strategy helps stabilize blood sugar levels and prevents the stomach from becoming too empty or too full, both of which can trigger nausea. Clinical guidelines widely support this dietary adjustment as a primary intervention for nausea and vomiting in pregnancy

A. Venipuncture for blood work should be performed on the affected arm. B. The blood pressure (BP) cuff should not be applied to the affected arm. C. The affected arm should be held down close to the woman's side. D. The affected arm should be used for intravenous (IV) therapy. E. The affected arm should be used for intravenous (IV) therapy.

Correct Answer is B

Explanation

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.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

What is the best nursing intervention for a pregnant woman in her third trimester who complains of feeling faint, dizzy, and agitated while her vital signs are being assessed?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A pregnant woman experiencing nausea and vomiting should:

Correct Answer is D

Explanation

What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

Correct Answer is B

Explanation

The hormone responsible for maturation of mammary gland tissue is:

Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI) include: (Select all that apply.)

The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on February 13th. Which date is most accurate?

A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicated that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record?

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have?

The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:

The nurse is counseling a woman who wants to become pregnant. The woman tells the nurse that she has a 28-day menstrual cycle and the first day of her menstrual period was January 8. The nurse correctly calculates that the woman's next fertile period is?

What is the result of a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period?