A pregnant woman complains of constipation frequently during pregnancy. The reason a nurse can explain could be?

Appeared in: NHM MP Staff Nurse - 2015

Explanation

The primary cause of constipation in pregnancy is the slowing of gastrointestinal (GI) peristalsis.
Elevated levels of the hormone progesterone cause relaxation of the smooth muscles of the intestines.
This reduced motility increases the transit time of stool in the colon, leading to greater water absorption.
As more water is absorbed, the stool becomes harder, drier, and more difficult to pass, resulting in constipation.

Option A: While some individuals may experience constipation with high milk intake, it is not the primary physiological reason for constipation that affects most pregnant women. The hormonal effect on the gut is a more universal cause.
Option C: The basal metabolic rate (BMR) actually increases during pregnancy to support fetal growth. Changes in metabolic rate are not a direct cause of slowed bowel movements.
Option D: The growing uterus presses on the intestines and sigmoid colon, which can contribute to constipation, especially in the third trimester. However, it does not directly pressure the anus, and the hormonal slowing of peristalsis is the primary cause throughout pregnancy.

Clinical Relevance

Nursing practice connection: Use the key finding related to Physiological causes of constipation during pregnancy to guide bedside assessment, documentation, and the next nursing action.
Nurses must educate pregnant patients that constipation is a common and normal discomfort of pregnancy, which can help reduce anxiety.
Providing dietary and lifestyle modifications (increased fiber, fluids, and activity) is the first-line nursing intervention for managing constipation.
It is crucial to advise patients to consult their healthcare provider before taking any over-the-counter laxatives, as some are not safe during pregnancy.

How to Approach the Question

First, identify the core of the question: it asks for the physiological reason for a common complaint during pregnancy (constipation).
Recall the major physiological changes in pregnancy. Think about hormonal, mechanical, and metabolic changes.
Evaluate each option against this knowledge.
Option A (Milk): This is a dietary factor, not a universal physiological change.
Option B (Slowing of GI movement): This relates to hormonal effects. Progesterone is known to relax smooth muscle. This is a strong candidate.
Option C (Metabolic rate): The metabolic rate increases, not decreases, so this is unlikely to cause slowing.

Concept Tested & Keywords

Concept Tested: Physiological causes of constipation during pregnancy.
Stem keywords: pregnant woman, constipation, pregnancy, reason
Lead-in keywords: could be
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 25-27

E6 Physiology Guyton 4SAE Part 2B p. 1-3

Practise the full NHM MP Staff Nurse - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.