Review Respiratory Changes in pregnancy

Physiological And Physical Changes In Pregnancy > Maternal & Newborn

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Respiratory Changes in pregnancy

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Total Questions : 5

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Question 1:

A nurse is teaching a pregnant client about the respiratory changes that occur during pregnancy.

The nurse should explain that the increased oxygen consumption is due to:.

A. Increased metabolic rate and fetal oxygen demand. B. Increased progesterone levels and sensitivity to carbon dioxide. C. Elevation of the diaphragm and increased chest wall compliance. D. Increased tidal volume and respiratory rate.

Answer and Explanation

Choice A:

Increased metabolic rate and fetal oxygen demand are not the main causes of increased oxygen consumption during pregnancy. The maternal rate of oxygen consumption rises progressively during pregnancy, reaching a peak of 20% above nonpregnant levels . The fetal oxygen demand is only a small fraction of this increase .

Choice B:

Increased progesterone levels and sensitivity to carbon dioxide. Progesterone is a hormone that increases during pregnancy and acts as a trigger of the primary respiratory center by increasing the sensitivity of the respiratory center to carbon dioxide . This leads to an increase in ventilation and oxygen consumption during pregnancy

Choice C:

Elevation of the diaphragm and increased chest wall compliance are mechanical effects of pregnancy that reduce the lung volumes and capacities, such as functional residual capacity and expiratory reserve volume . These changes do not affect the oxygen consumption directly.

Choice D:

Increased tidal volume and respiratory rate are the consequences of increased oxygen consumption during pregnancy, not the causes. Tidal volume increases by 40% and respiratory rate increases by 15% during pregnancy . These changes result in an increase in minute ventilation by 50% .

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Question 2:

A nurse is assessing a pregnant client who is in her third trimester.

The nurse notes that the client has a functional residual capacity of 1.8 L.

The nurse should recognize that this finding indicates:.

A. A normal respiratory change in pregnancy caused by the gravid uterus. B. An abnormal respiratory change in pregnancy caused by pulmonary edema. C. A normal respiratory change in pregnancy caused by increased alveolar ventilation. D. An abnormal respiratory change in pregnancy caused by asthma.

Answer and Explanation

Choice A:

A normal respiratory change in pregnancy caused by the gravid uterus. This is because the enlarging uterus increases the end-expiratory abdominal pressure and displaces the diaphragm upwards, leading to a reduction of functional residual capacity (FRC) and expiratory reserve volume (ERV) . FRC is the volume of air remaining in the lungs after a normal expiration. The normal FRC for an adult is about 2.4 L, so a value of 1.8 L indicates a decrease of about 25% .

Choice B:

Pulmonary edema is not a normal respiratory change in pregnancy, but a complication that can occur due to pre-eclampsia, heart failure, or fluid overload. Pulmonary edema would cause symptoms such as dyspnea, cough, chest pain, and frothy sputum.

Choice C:

Increased alveolar ventilation is not caused by FRC reduction, but by increased levels of progesterone that stimulate the respiratory center and increase the sensitivity to carbon dioxide . Alveolar ventilation is the amount of air that reaches the alveoli per minute. Increased alveolar ventilation leads to increased oxygen consumption and decreased carbon dioxide levels in pregnancy.

Choice D:

Asthma is not a normal respiratory change in pregnancy, but a chronic inflammatory condition that affects the airways. Asthma can cause symptoms such as wheezing, coughing, chest tightness, and shortness of breath. Asthma can worsen or improve during pregnancy depending on various factors such as hormonal changes, allergen exposure, and stress.

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Question 3:

A woman is in her seventh month of pregnancy.

She has been complaining of nasal congestion and occasional epistaxis.

The nurse suspects that:.

A. This is a normal respiratory change in pregnancy caused by elevated levels of estrogen. B. This is an abnormal cardiovascular change, and the nosebleeds are an ominous sign. C. The woman is a victim of domestic violence and is being hit in the face by her partner. D. The woman has been using cocaine intranasally.

Answer and Explanation

Choice A:

This is a normal respiratory change in pregnancy caused by elevated levels of estrogen. Estrogen increases the blood volume and the vascularity of the nasal mucosa, making it more prone to congestion and bleeding. This condition is called pregnancy rhinitis and affects up to 39% of pregnant people. It usually resolves within 10 days after delivery.

Choice B:

Nasal congestion and epistaxis are not signs of cardiovascular problems in pregnancy. They are common and benign symptoms that do not indicate any complications.

Choice C:

Here is no evidence that the woman is a victim of domestic violence. Domestic violence is a serious issue that should not be assumed without proper assessment and screening. If there are any signs of physical or emotional abuse, the nurse should provide support and referral to appropriate resources.

Choice D:

Cocaine use is not a likely cause of nasal congestion and epistaxis in pregnancy. Cocaine can cause damage to the nasal septum and mucosa, but it would also cause other symptoms such as agitation, tachycardia, hypertension, and fetal distress. Cocaine use in pregnancy is associated with increased risks of miscarriage, preterm labor, placental abruption, and fetal growth restriction. The nurse should ask about substance use history and offer counseling and treatment if

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Question 4:

A nurse is caring for a pregnant client who reports dyspnea and nasal congestion.

The nurse should inform the client that these symptoms are:.

A. Normal or abnormal depending on the severity, duration, and frequency. B. Normal and expected due to the respiratory changes in pregnancy. C. Abnormal and suggestive of a respiratory infection or allergy. D. Abnormal and indicative of a cardiovascular complication.

Answer and Explanation

Choice A:

Because these symptoms are not dependent on the severity, duration, or frequency, but rather on the stage of pregnancy and the individual response to hormonal changes.

Choice B:

Normal and expected due to the respiratory changes in pregnancy. This is because pregnancy causes hormonal changes such as increased estrogen levels and high blood volume, which can lead to swelling of the blood vessels and mucus membranes in the nose, resulting in nasal congestion or pregnancy rhinitis. Pregnancy also increases the oxygen demand and carbon dioxide production, which can cause dyspnea or breathing discomfort. These symptoms are usually physiologic and do not indicate any underlying diseas

Choice C:

Wrong because these symptoms are not suggestive of a respiratory infection or allergy, unless there are other signs such as fever, cough, sneezing, or itching.

Choice D:

Wrong because these symptoms are not indicative of a cardiovascular complication, unless there are other signs such as chest pain, palpitations, edema, or cyanosis.

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Question 5:

A nurse is reviewing the laboratory results of a pregnant client who has been ingesting white clay dirt from her backyard.

The nurse should expect to find:.

A. An elevated hemoglobin level. B. A decreased platelet count. C. An increased glucose level. D. A reduced iron level.

Answer and Explanation

Choice A:

wrong because an elevated hemoglobin level is not likely to result from clay ingestion. Hemoglobin is the protein that carries oxygen in the blood and it requires iron for its synthesis. If iron levels are reduced due to clay ingestion, hemoglobin levels will also be reduced.

Choice B:

decreased platelet count is not directly related to clay ingestion. Platelets are blood cells that help with clotting and they are not affected by the mineral content of clay. However, clay ingestion may increase the risk of bleeding due to iron deficiency anemia.

Choice C:

Wrong because an increased glucose level is not caused by clay ingestion. Glucose is the main source of energy for the body and it is regulated by hormones such as insulin.

Choice D:

A reduced iron level. This is because ingesting white clay dirt from the backyard, also known as calabash chalk or nzu, can bind iron and other minerals in the intestine and prevent their absorption. This can lead to iron deficiency anemia and other complications for the pregnant woman and the unborn child.

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Respiratory Changes in pregnancy

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