A 32-year-old primipara who is 8 weeks' gestation asks you if she should expect any respiratory changes as her pregnancy progresses. What should the nurse tell her?
1. "By the third trimester, you will no longer feel as though you're short of breath."
2. "If you develop shortness of breath, it should improve in the last few weeks of your pregnancy, as lightening occurs."
3. "Shortness of breath is an abnormal finding during any stage of pregnancy, and it's considered a serious complication."
4. "You may experience shortness of breath due to stretching of the round ligament."
Correct Answer: 2
Rationale 1: Shortness of breath occurs as the uterus rises into the abdomen and causes pressure on the diaphragm. This problem worsens in the last trimester.
Rationale 2: The primigravida experiences considerable relief from shortness of breath in the last few weeks of pregnancy, when lightening occurs and the fetus and uterus move down in the pelvis.
Rationale 3: Because of decreased vital capacity from pressure of the enlarging uterus on the diaphragm, shortness of breath is a common problem of pregnancy.
Rationale 4: Round ligament stretching causes a "grabbing" sensation in the lower abdomen and inguinal area.
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