A 21-year-old at 12 weeks' gestation with her first baby has known cardiac disease, class III, as a result of childhood rheumatic fever. During a prenatal visit, the nurse reviews the signs of cardiac decompensation with her

Question

The nurse will know that the patient understands these signs and symptoms if she states, "I would notify my doctor if I had: 1. "A pulse rate increase of 10 beats per minute."
2. "Breast tenderness."
3. "Mild ankle edema."
4. "A frequent cough."

Answer 1

4
Rationale 1: In most pregnant patients , the heart rate will increase.
Rationale 2: Most pregnant patients will develop breast tenderness.
Rationale 3: The patient with rheumatic heart disease who develops congestive heart failure would have severe ankle edema.
Rationale 4: With the increased workload of the heart with pregnancy and the increase in blood volume, this patient is at risk for developing congestive heart failure. This would result in the frequent cough.