The nurse understands that the pregnancy is progressing normally when she sees which of the following physiologic changes 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 hip pain.
2. The cervix is firm and purplish–blue in color.
3. The uterine fundus is at a height of 35 cm above the pubic symphysis.
4. Gastric emptying time is prolonged, and the patient complains of gas and bloating.
5. Supine hypotension, creating dizziness, occurs when the patient 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 hip or pubic symphysis pain in late pregnancy.
2. Cervical changes during pregnancy include softening and purplish–blue discoloration.
3. The growing fetus causes an enlargement of the uterus; from 20 weeks until delivery, the fundal height measured in cm should be within 2–3 of the number of weeks' gestation.
4. Gas 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.