. The client is admitted to the prenatal clinic. A history of cardiac disease exists. If the client is a class II cardiac client, the nurse should teach the client to: ? A. Remain on strict bed rest during her pregnancy ? B. Plan to have a therapeutic abortion ? C. Avoid strenuous exercise ? D. Use oxygen at night

When managing a pregnancy complicated by cardiac disease, prenatal care must be tailored to address the unique needs of the patient. A woman with a class II cardiac condition has a slight limitation of physical activity. She is comfortable at rest, but ordinary physical activity causes symptoms such as fatigue, palpitation, or dyspnea.

Therefore, it's crucial to balance rest and activity for these patients. Rather than strict bed rest, which can lead to complications like thromboembolism, the focus should be on avoiding activities that cause cardiac stress. They should be encouraged to maintain a healthy lifestyle with regular, gentle exercise such as walking or swimming, tailored to their cardiovascular capacity and obstetric status. Education on recognizing the signs of overexertion and understanding the importance of seeking medical help if symptoms worsen is essential. Moreover, monitoring for potential obstetric complications that can exacerbate cardiac issues is a critical element of prenatal care for these patients.

Additionally, regular follow-ups with a cardiologist and a high-risk pregnancy specialist are pivotal to ensuring the safety of both mother and child. Personalized birth plans that include a strategy for labor and delivery, which may vary in invasiveness based on the mother's cardiac status, should also be prepared.

The management of cardiac disease in pregnancy requires a multidisciplinary approach that includes obstetricians, cardiologists, and primary healthcare providers. It's important to optimize the cardiac condition before pregnancy if possible, and closely monitor the mother throughout the gestational period.

Mild to moderate exercise can contribute positively to overall cardiovascular health during pregnancy and may include activities tailored to the patient's tolerance, such as walking or prenatal yoga. Additionally, the avoidance of stimulants, strict adherence to a heart-healthy diet low in sodium and rich in nutrients, and the successful management of stress are all integral parts of managing cardiac disease in pregnancy.

The postpartum period also warrants attention, as the physiological changes revert back, adjust, and the mother experiences new demands such as breastfeeding and adapting to a different sleep cycle. Regular postpartum checkups can help to identify and manage any lingering or new cardiac issues.

For nursing students preparing for the NCLEX-PN exam, understanding how to manage patients with cardiac disease during pregnancy is essential. Students should be well-versed in the physiological changes during pregnancy that can affect pre-existing cardiac conditions, as well as the standard prenatal care practices for cardiac patients.

When studying for the NCLEX, it's beneficial to engage in active learning techniques such as practicing with sample questions, taking part in study groups, and using flashcards. Reviewing case studies similar to the example given in the original exercise helps students apply theoretical knowledge to practical scenarios. Considering the rationale behind each correct and incorrect answer choice is key to developing critical thinking skills that the NCLEX requires.

Lastly, managing time effectively during preparation, practicing self-care to reduce stress, and consistently reviewing material can help ensure students are well-prepared to tackle questions related to cardiac disease management during pregnancy on the NCLEX-PN exam.