A 36-year-old primigravida at 22 weeks’ gestation, experiencing no complications to date, is seen in the nurse midwife’s office for a routine visit. While lying supine on the examination table, she tells the nurse that she is feeling dizzy. After observing that the client is pale and perspiring freely, which of the following would the nurse do first?
a) Turn the client onto her left side.
b) Obtain the client’s pulse and blood pressure.
c) Assess the client for vaginal spotting.
d) Lower the client’s head between her knees.
Answer: A
RATIONALE: Pressure on the vena cava from the enlarging uterus, commonly referred to as vena cava syndrome or supine hypotensive syndrome is the most common reason a pregnant client may feel dizzy, become pale, and perspire freely when lying supine. Thus, the nurse needs to relieve this pressure by turning the client onto her left side.
Measuring the client’s blood pressure, pulse, and respirations may be performed once the client is positioned on her left side.
The signs and symptoms manifested by the client are unrelated to vaginal spotting.
Lowering the client’s head is not as helpful or effective as positioning her on her left side.
a) Turn the client onto her left side.
b) Obtain the client’s pulse and blood pressure.
c) Assess the client for vaginal spotting.
d) Lower the client’s head between her knees.
Answer: A
RATIONALE: Pressure on the vena cava from the enlarging uterus, commonly referred to as vena cava syndrome or supine hypotensive syndrome is the most common reason a pregnant client may feel dizzy, become pale, and perspire freely when lying supine. Thus, the nurse needs to relieve this pressure by turning the client onto her left side.
Measuring the client’s blood pressure, pulse, and respirations may be performed once the client is positioned on her left side.
The signs and symptoms manifested by the client are unrelated to vaginal spotting.
Lowering the client’s head is not as helpful or effective as positioning her on her left side.