A prenatal client with a history of migraine headache has been instructed on care at home. Which statement if made by the client would indicate that the client understands her needs?

1. A

   There is no restriction on people who visit me

2. B

   I should avoid stressful situations

3. C

   My weight gain is not important

4. D

   I should rest on my right side

Appeared in: SJH Nursing Officer - 2019

Explanation

• Stress is a major and well-established trigger for migraine headaches.
• Avoiding stressful situations is a key non-pharmacological strategy for reducing the frequency and severity of migraine attacks.
• This approach is particularly important during pregnancy, as many standard migraine medications are contraindicated or must be used with caution.
• This statement demonstrates the client has understood a critical component of her self-care plan to prevent migraines.

Why Other Options Were Wrong

• Option A: This statement shows a lack of awareness that social situations, noise, and light from visitors can be significant stressors and triggers for migraines. While not an absolute rule, managing the environment is key.
• Option C: This statement is fundamentally incorrect and dangerous in a prenatal context. Adequate and appropriate weight gain is essential for fetal growth and a healthy pregnancy outcome.
• Option D: The recommended resting position during the second and third trimesters of pregnancy is the left lateral position. This prevents supine hypotensive syndrome by avoiding compression of the inferior vena cava and ensures optimal blood flow to the fetus.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Client education and self-care for migraine management during pregnancy to guide bedside assessment, documentation, and the next nursing action.
• A nurse's primary role is to educate pregnant clients on non-pharmacological methods to manage chronic conditions like migraines, prioritizing both maternal well-being and fetal safety.
• Patient teaching should always include identifying and avoiding personal migraine triggers, such as stress, certain foods, lack of sleep, and environmental factors.
• It is critical to correct misconceptions about fundamental aspects of prenatal care, such as the importance of weight gain and proper maternal positioning.

How to Approach the Question

• First, identify the core of the question: it's testing your knowledge of correct self-care instructions for a pregnant client with migraines.
• Evaluate each option against established principles of both migraine management and prenatal care.
• Analyze Option A: Is limiting visitors a standard recommendation? Not always, but managing environmental stress is. This option is weak.
• Analyze Option B: Is stress a migraine trigger? Yes, it's a major one. Avoiding it is a key non-pharmacological strategy, especially in pregnancy. This is a very strong candidate.
• Analyze Option C: Is weight gain unimportant in pregnancy? No, this is fundamentally incorrect and contradicts basic prenatal teaching.
• Analyze Option D: Is resting on the right side recommended? No, the left side is recommended to promote fetal circulation. This is incorrect.

Concept Tested & Keywords

• Concept Tested: Client education and self-care for migraine management during pregnancy.
• Stem keywords: prenatal client, migraine headache, care at home, understands her needs
• Lead-in keywords: indicates that the client understands
• Clinical cues: The client is pregnant, which limits pharmacological options and emphasizes lifestyle management.
• Clinical cues: The client has a history of migraines, indicating a need to manage known triggers.

Question ID

Qkhf_smvLlwNcBStdJY2jb

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 55-57