PMC PMC Circulatory & Lymphatic Considerations 2 — Questions and Answers
Question 1: What is supine hypotensive syndrome and when does it most commonly occur?
- A drop in blood pressure caused by uterine compression of the vena cava when lying supine, most common after 20 weeks (Correct answer)
- High blood pressure triggered by lying on the left side after 30 weeks
- Dizziness caused by dehydration in the first trimester
- A cardiac arrhythmia associated with late pregnancy
Correct answer: A drop in blood pressure caused by uterine compression of the vena cava when lying supine, most common after 20 weeks
After 20 weeks, the enlarged uterus can compress the inferior vena cava when supine, reducing cardiac return and causing hypotension.
Question 2: How does the left lateral recumbent position benefit a pregnant client's circulation?
- It shifts the uterus off the inferior vena cava, improving venous return to the heart (Correct answer)
- It increases fetal heart rate for better monitoring
- It reduces lumbar lordosis by compressing the spine
- It decreases blood flow to the placenta, reducing pressure
Correct answer: It shifts the uterus off the inferior vena cava, improving venous return to the heart
The left lateral position moves the uterus leftward, relieving compression on the vena cava and aorta, optimizing maternal and fetal circulation.
Question 3: Which hormone is primarily responsible for the vasodilation and increased cardiovascular output seen in early pregnancy?
- Progesterone (Correct answer)
- Estrogen
- Oxytocin
- Cortisol
Correct answer: Progesterone
Progesterone relaxes smooth muscle in blood vessel walls, causing vasodilation and a compensatory increase in cardiac output.
Question 4: Why is generalized pitting edema in the ankles and feet considered a normal finding in late pregnancy?
- Increased venous pressure from the growing uterus impairs lymphatic drainage in the lower extremities (Correct answer)
- The kidneys reduce urine output causing fluid retention throughout the body
- Fetal movement compresses lymph nodes in the abdomen
- Relaxin causes capillary permeability in the feet only
Correct answer: Increased venous pressure from the growing uterus impairs lymphatic drainage in the lower extremities
The enlarged uterus compresses pelvic veins and lymphatics, slowing return flow and causing dependent edema in the feet and ankles.
Question 5: When performing lymphatic drainage on a pregnant client, what is the recommended direction for light effleurage on the arm?
- From hand toward the axillary lymph nodes (Correct answer)
- From shoulder toward the fingertips
- In a circular motion around the elbow
- Across the forearm perpendicular to the limb
Correct answer: From hand toward the axillary lymph nodes
Manual lymphatic drainage always moves fluid toward regional lymph nodes; in the arm, this means moving from the periphery toward the axilla.
Question 6: A pregnant client in her third trimester reports her wedding ring no longer fits due to hand swelling. The therapist should:
- Assess whether the edema is bilateral and pitting, note it in the chart, and use gentle lymphatic techniques (Correct answer)
- Apply deep compression to the hands to force the fluid out
- Advise the client to see a doctor before receiving any massage
- Avoid touching the hands entirely for the remainder of pregnancy
Correct answer: Assess whether the edema is bilateral and pitting, note it in the chart, and use gentle lymphatic techniques
Bilateral, non-pitting hand swelling is common in late pregnancy; gentle lymphatic techniques and proper documentation are the appropriate response.
PMC PMC Circulatory & Lymphatic Considerations 2
What is supine hypotensive syndrome and when does it most commonly occur?