Question

A nurse in an antepartum clinic answers a phone call from a client who is at 37 weeks of gestation and reports, "I became very dizzy while lying in bed this morning, but the feeling went away when I turned on my side." Which of the following actions should the nurse take?

A. Instruct the client about vena cava syndrome and measures to prevent it.
B. Arrange for the client to come to the clinic for an assessment.
C. Check the client's chart for gestational diabetes mellitus.
D. Schedule a nonstress test for the client.

Answer 1

The nurse should instruct the client about vena cava syndrome and how lying on the side can help prevent it, as the condition arises from the pregnant uterus compressing the inferior vena cava, leading to reduced blood flow and dizziness.

Step-by-step explanation:

A client at 37 weeks of gestation reports feeling very dizzy while lying in bed, but the sensation went away when turning on their side. The nurse should instruct the client about vena cava syndrome (supine hypotension syndrome) and measures to prevent it. This condition occurs when the pregnant uterus compresses the inferior vena cava when the mother is lying on her back, which can reduce blood return to the heart and may lead to dizziness or other symptoms. Turning on the side, especially the left side, helps alleviate this compression, allowing for better blood flow.

The nurse can provide education on how to prevent vena cava syndrome by advising the client to avoid lying flat on their back during the last trimester and instead suggest lying on the side with a pillow behind the back or under one hip to maintain a tilt. It is notably important as the fetus grows and the uterus expands, increasing the potential for compression on the vena cava when the mother is supine. Simple repositioning can significantly improve maternal and fetal circulation.