Maternity Nursing Q 183
A gravidocardiac mother is advised to observe bed rest primarily to:
A. Allow the fetus to achieve normal intrauterine growth.
B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother.
C. Prevent perinatal infection.
D. Reduce incidence of premature labor.
Correct Answer: B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother.
The activity of the mother will require more oxygen consumption. Since the heart of a gravido-cardiac is compromised, there is a need to put a mother on bedrest to reduce the need for oxygen.
Option A: In cases of maternal decompensation, fetal monitoring should also be done to ensure fetal well-being. Women with moderate-risk or high-risk lesions, especially cyanotic lesions, have an increased risk of fetal growth restriction and should be followed with monthly ultrasound examinations for fetal growth.
Option C: The 2011 update to the American Heart Association guideline for the prevention of cardiovascular disease (CVD) in women recommends that risk assessment at any stage of life include a detailed history of pregnancy complications. Gestational diabetes, preeclampsia, preterm birth, and birth of an infant small for gestational age are ranked as major risk factors for CVD.
Option D: During the third trimester, cardiac output is further influenced by body position, where the supine position causes caval compression by the gravid uterus. This leads to a decrease in venous return, which can cause supine hypotension of pregnancy. Stroke volume normally increases in the first and second trimester and decreases in the third trimester. This decrease is due to partial vena cava obstruction.