The nurse understands that a client's pregnancy is progressing normally when which of the following physiologic changes are documented on the prenatal record of a woman at 36 weeks' gestation? Select all that apply

Question

1. The joints of the pelvis have relaxed, causing a waddling gait.
2. The cervix is firm and purplish–blue in color.
3. The uterus vasculature contains one-sixth of the total maternal blood volume.
4. Gastric emptying time is prolonged, and the client complains of constipation and bloating.
5. Supine hypotension, creating dizziness, occurs when the client lies on her back.

Answer 1

1; 3; 4; 5
Rationale:
1. The pregnancy hormone relaxin creates softening of the ligaments, which in turn can lead to a waddling gait.
2. Cervical changes during pregnancy include softening and purplish–blue discoloration.
3. The growing fetus causes an enlargement of the uterus; by the end of pregnancy, one-sixth of the total maternal blood volume is contained within the vascular system of the uterus.
4. Constipation and bloating are seen as the increased progesterone level causes smooth muscle relaxation, resulting in delayed gastric emptying and slowed peristalsis.
5. Supine hypotension occurs when the fetus compresses the vena cava against the vertebrae when the mother is supine, thus reducing blood flow to the right atrium, lowering blood pressure, and causing dizziness, pallor, and clamminess.