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Difficulty: EasyAnte/Intra/Postpartum and Newborn Care

During a routine prenatal visit, a pregnant client at 35 weeks of gestation is resting flat on her back on the examination table. She suddenly reports feeling dizzy, severely nauseated, and lightheaded. The nurse observes that her skin is noticeably pale and diaphoretic. Which action should the nurse take first?

  1. Guide the client to roll onto her left lateral side.Answer
  2. B
    Apply a nonrebreather mask to deliver supplemental oxygen.
  3. C
    Obtain a capillary blood glucose reading to check for hypoglycemia.
  4. D
    Prop the client's head and shoulders up with two pillows.

Answer

The nurse should immediately guide the client to roll onto her left lateral side to relieve compression of the inferior vena cava.
Turning the client to a side-lying position physically displaces the heavy gravid uterus off the inferior vena cava. This immediate anatomical shift restores venous blood return to the heart, rapidly resolving the maternal hypotension, dizziness, and pallor.

Step-by-Step Solution

1
Recognize the clinical presentation.
Identify dizziness, pallor, and diaphoresis in a supine pregnant client as classic signs of supine hypotensive syndrome.
The heavy gravid uterus compresses the inferior vena cava when the client is flat on her back, severely reducing venous return to the heart.
2
Implement the priority nursing intervention.
Shift the client into a side-lying (lateral) position.
Tilting the client laterally physically displaces the uterus off the major vessels, immediately restoring cardiac output and blood pressure.

Key Concept

Supine Hypotensive Syndrome management
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Topics

Ante/Intra/Postpartum and Newborn Care

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