A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis. What is the correct interpretation of these symptoms by the practitioner?
a. These conditions are abnormal. Refer the patient to an ear, nose, and throat
specialist.
b. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
c. Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and
epistaxis are within normal limits.
d. Estrogen causes increased blood supply to the mucous membranes and can result
in congestion and nosebleeds.
D
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A The patient should be reassured that these symptoms are within normal limits.
No referral is needed at this time.
B Progesterone is responsible for the heightened awareness of the need to breathe
in pregnancy. Progesterone levels increase during pregnancy.
C Progesterone affects relaxation of the smooth muscles in the respiratory tract.
D As capillaries become engorged, the upper respiratory tract is affected by the
subsequent edema and hyperemia, which causes these conditions, seen
commonly during pregnancy.
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