Maternity Nursing: Antepartum Q 25

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An expected cardiopulmonary adaptation experienced by most pregnant women is:

  

     A. Tachycardia

     B. Dyspnea at rest

     C. Progression of dependent edema

     D. Shortness of breath on exertion

    

    

Correct Answer: D. Shortness of breath on exertion.

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This is an expected cardiopulmonary adaptation during pregnancy; it is caused by an increased ventricular rate and elevated diaphragm.

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Option A: In pregnancy, the cardiac output increases 30 to 60%, with the majority of the increase occurring during the first trimester. The maximum output is reached between 20 and 24 weeks and is maintained until delivery. Initially, the increase in cardiac output is due to an increase in stroke volume. As the stroke volume decreases towards the end of the third trimester, an increase in heart rate acts to maintain the increased cardiac output.

Option B: During pregnancy, the diaphragm elevates, resulting in a 5% decrease in total lung capacity (TLC). However, the tidal volume (TV) increases by 30 to 40%, thereby decreasing the expiratory reserve volume by 20%. Minute ventilation is similarly increased by 30 to 40%, owing to the fact that TV becomes increased while a constant respiratory rate is maintained.

Option C: During pregnancy, the extra fluid in the body and the pressure from the growing uterus can cause swelling (edema) in the ankles and feet. The swelling tends to get worse as a woman’s due date nears, particularly near the end of the day and during hotter weather.

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