The nurse is caring for a pregnant woman with congenital heart disease. The woman asks if she will be able to have a vaginal delivery. Which answer by the nurse is correct?

Correct Answer: C

Rationale: A vaginal birth is preferred over a Cesarean section for women who have aortic stenosis. Aortic stenosis is a type of congenital heart disease that restricts blood flow from the heart to the rest of the body due to a narrowing of the aortic valve. In women with aortic stenosis, the increased blood volume and heart rate during labor and delivery can put extra strain on the heart. However, in most cases, vaginal delivery is preferred over a Cesarean section to avoid the risks associated with major abdominal surgery, such as bleeding, infection, and thrombophlebitis. A vaginal birth allows for a more gradual and controlled increase in cardiac output compared to the more sudden changes that can occur during a Cesarean section. Additionally, the stress of labor may mimic the stress test for some patients, providing valuable information about their heart function. However, each case is unique and must be evaluated by the healthcare team

Correct Answer: A

Rationale: Disseminated intravascular coagulation (DIC) is a complex, life-threatening condition characterized by widespread activation of coagulation within the blood vessels. In the early stages of DIC, there is excessive clot formation (formation of small clots) throughout the body due to the dysregulation of coagulation factors. As the disease progresses, the body's clotting factors become depleted, leading to a state of systemic anticoagulation. This anticoagulant state increases the risk of hemorrhage (bleeding) as the blood is no longer able to adequately clot. Therefore, hemorrhage is a pathological change that occurs late in the course of DIC.

Correct Answer: B

Rationale: The renal system plays a crucial role in regulating blood pressure through various mechanisms. Renin is an enzyme released by the kidneys in response to low blood pressure or low blood volume. Renin acts on angiotensinogen to convert it into angiotensin I, which is further converted into angiotensin II by angiotensin-converting enzyme (ACE) in the lungs. Angiotensin II is a potent vasoconstrictor, leading to an increase in blood pressure by constricting blood vessels. Additionally, angiotensin II stimulates the release of aldosterone, a hormone that promotes sodium and water retention in the kidneys, leading to an increase in blood volume and further elevating blood pressure. Therefore, the release of renin by the renal system ultimately leads to an increase in blood pressure.

Correct Answer: A

Rationale: Consuming caffeinated coffee can potentially contribute to cardiac dysrhythmias in susceptible individuals. Caffeine is a stimulant that can increase heart rate and blood pressure, leading to arrhythmias in some people. Regular intake of caffeinated beverages can disrupt the normal electrical activity of the heart, especially in those with underlying cardiac conditions. Therefore, the nurse would identify drinking caffeinated coffee as a possible contributing factor to the client's dysrhythmia.

Correct Answer: C

Rationale: Patients with peripheral vascular disease (PVD) often undergo percutaneous transluminal angioplasty (PTA) as a non-surgical intervention to improve blood flow in the affected arteries. PTA involves the use of a catheter with a balloon at its tip, which is inflated at the site of arterial narrowing to widen the vessel by compressing the plaque and stretching the arterial walls. This procedure helps restore blood flow and can alleviate symptoms such as claudication and ischemia in patients with PVD. Stent placement, endarterectomy, and atherectomy are other interventions that may be used in the management of PVD, but PTA is specifically known for its role in improving arterial blood flow in these patients.