To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that:
a. A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia 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.
ANS: B
Auscultatory changes should be discernible after 20 weeks of gestation. A healthy woman with no underlying heart disease does not need any therapy. The maternal heart rate increases in the third trimester, but palpitations may not occur. Auditory changes are discernible at 20 weeks.
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