In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down flat on my back." The nurse explains that this is due to:
A) Pressure of the gravid uterus on the vena cava
B) A 50% increase in blood volume
C) Physiologic anemia due to hemoglobin decrease
D) Pressure of the presenting fetal part on the diaphragm
A
Response:
The client is describing symptoms of supine hypotension syndrome, which occurs when the heavy gravid uterus falls back against the superior vena cava in the supine position. The vena cava is compressed, reducing venous return, cardiac output, and blood pressure, with increased orthostasis. The increased blood volume and physiologic anemia are unrelated to the client's symptoms. Pressure on the diaphragm would lead to dyspnea.
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