What is the most likely cause of her first-trimester reflux?
A 29-year-old homemaker who is G4P3 comes to your clinic for her first prenatal check. Her last period was 2 months ago. She has had three previous pregnancies and deliveries with no complications. She has no medical problems and has had no surgeries. Her only current complaint is of severe reflux that occurs in the mornings and evenings. On examination she is in no acute distress. Her vitals are 110/70 with a pulse of 88. Her respirations are 16. Her head, eyes, ears, nose, throat, thyroid, cardiac, pulmonary, and abdominal examinations are unremarkable. On bimanual examination her cervix is soft and her uterus is 10 weeks in size. Pap smear, cultures, and blood work are pending.
A) Increasing prolactin levels
B) Increasing ADH (antidiuretic hormone) levels
C) Increasing progesterone
D) Enlarged gravid uterus
C) Increasing progesterone
Progesterone lowers the esophageal sphincter tone, leading to reflux and heartburn. It also relaxes tone and contraction of the ureters and bladder, increasing risk of UTI and subsequent bacteremia.
You might also like to view...
A patient is instructed to take diphenhydramine (Benadryl) after an allergic reaction. Which of the following statements by the patient indicates successful teaching concerning the administration of diphenhydramine (Benadryl)?
A) "I will still be able to have my after-dinner drink with this medication." B) "I will eat a diet low in sodium while taking this medication." C) "I should not drive my car after taking this medication." D) "I can take this medication every 2 hours until I feel better."
The nurse measures pulse rate on a young adult male and obtains a rate of 44 per minute. The nurse would consider this pulse rate normal if which of the following data were assessed?
1. The client is on Lanoxin (digoxin) for heart disease. 2. The client is an athlete. 3. The client has Kawasaki's disease. 4. The client has a congenital cardiac defect.
A 53-year-old patient with a history of dysrhythmias is to wear a Holter monitor. The nurse should explain that Holter monitoring
a. is a form of stress test. b. amplifies heart sounds. c. is a portable electrocardiographic device. d. regulates heart rate.
When interviewing with the nurse manager, the new nurse should be prepared to ask about:
a. Availability of on-site banking. b. Timing of evaluations. c. Benefits. d. Parking.