Maternity Nursing: Antepartum Q 42
A pregnant woman at 32 weeks’ gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. The nurse’s initial response would be to:
A. Assess the woman’s blood pressure and pulse.
B. Have the woman breathe into a paper bag.
C. Raise the woman’s legs.
D. Turn the woman on her left side.
Correct Answer: D. Turn the woman on her left side.
During a fundal height measurement, the woman is placed in a supine position. This woman is experiencing supine hypotension as a result of uterine compression of the vena cava and abdominal aorta. Turning her on her side will remove the compression and restore cardiac output and blood pressure.
Option A: After turning the client on the side, then vital signs can be assessed. Because this phenomenon is so well known, standard practice is for clinicians to avoid placing the woman in supine position for routine examinations and procedures, moving the woman into the left lateral if there are signs of fetal distress in labor, and also advising her to avoid the supine position herself, at least during the day.
Option B: Breathing into a paper bag is the solution for dizziness related to respiratory alkalosis associated with hyperventilation.
Option C: Raising her legs will not solve the problem since pressure will remain on the major abdominal blood vessels, thereby continuing to impede cardiac output.