Maternity Nursing Q 148
You are performing an abdominal exam on a 9th-month pregnant woman. While lying supine, she felt breathless, had pallor, tachycardia, and cold clammy skin. The correct assessment of the woman’s condition is that she is:
A. Experiencing the beginning of labor.
B. Having supine hypotension.
C. Having sudden elevation of BP.
D. Going into shock.
Correct Answer: B. Having supine hypotension.
Supine hypotension is characterized by breathlessness, pallor, tachycardia, and cold, clammy skin. This is due to the compression of the abdominal aorta by the gravid uterus when the woman is in a supine position.
Option A: The woman may be at the beginning of labor if the fetus drops or moves lower into the pelvis, increase in vaginal discharge that is clear, pink, or slightly bloody, and cervical effacement and dilatation occurs.
Option C: Preeclampsia occurs when hypertension develops after 20 weeks of pregnancy and is associated with signs of damage to other organ systems, including the kidneys, liver, blood, or brain. Untreated preeclampsia can lead to serious — even fatal — complications for mother and baby, including development of seizures (eclampsia).
Option D: Shock is a state of compromised tissue perfusion that causes cellular hypoxia and is defined as a syndrome initiated by acute hypoperfusion, leading to tissue hypoxia and vital organ dysfunction. The treatment of shock in a pregnant woman differs in two important respects from the treatment of shock in other adults. [1] First, normal physiologic changes occur in most organ systems during pregnancy. Second, the mother and the fetus are both vulnerable during pregnancy. Therefore, obstetric critical care involves simultaneous assessment and management of the mother and fetus, who have differing physiological profiles.