To reassure and educate pregnant patients about changes in their cardiovascular system, maternity nurses should be aware that:
a. A pregnant woman experiencing disturbed cardiac rhythm such as sinus arrhyth-mia requires close medical and obstetric observation, no matter how healthy she otherwise may appear.
b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.
c. Palpitations are twice as likely to occur in twin gestations.
d. All of the above changes likely will occur.
B
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A A healthy woman with no underlying heart disease does not need any therapy.
B These auscultatory changes should be discernible after 20 weeks of gestation.
C The maternal heart rate increases in the third trimester, but palpitations may not necessarily occur, let alone double.
D Auditory changes are discernible at 20 weeks.
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