A pregnant woman in her third trimester presents to the emergency department after fainting upon rising from a supine position. Which activity should the nurse perform first?
A.
Call the cardiology department for an EKG.
B.
Determine the fetal heart rate.
C.
Obtain a blood glucose reading.
D.
Teach her to rise slowly from a reclining position.
ANS: C
Supine hypotension is caused by the pressure of the enlarging uterus on the inferior vena cava while the woman is in a supine position. Vena caval compression impedes venous blood flow, reduces the amount of blood in the heart, and decreases cardiac output, causing dizziness and syncope. Pathological causes of supine hypotension include cardiac or respiratory disorders, anemia, hypoglycemia, dehydration, anxiety, and stress. Hypoglycemia can be treated rapidly if that is the cause. The other actions are appropriate as well, but the priority action would be to identify a condition that is readily treatable.
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