To reassure and educate their patients concerning changes in the cardiovascular system, maternity nurses should be aware that:
1. 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.
2. changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.
3. in twin gestations palpitations are twice as likely to occur.
4. all of the above changes will likely occur.
2
1. Incorrect. A healthy woman with no underlying heart disease will not need any therapy.
2. Correct. These auscultatory changes should be discernible after 20 weeks of gestation.
3. Incorrect. Maternal heart rate increases in the third trimester, but palpitations may not necessarily occur, let alone double.
4. Incorrect. Auditory changes are discernible in 20 weeks.
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