Which minor discomfort is commonly experienced during pregnancy due to increased progesterone causing relaxat… - NCL (Northern Coalfields Limited)-NO

NCL (Northern Coalfields Limited)-NO

Obstetrics & Gynaecology

Medium

Appeared in: NCL (Northern Coalfields Limited)-NO

Explanation

During pregnancy, the hormone progesterone has a relaxing effect on smooth muscles throughout the body.
The lower esophageal sphincter (LES), which prevents stomach contents from flowing back into the esophagus, is a smooth muscle.
Progesterone causes the LES to relax, leading to a backflow of stomach acid, which results in heartburn, also known as reflux disease.
This is a common gastrointestinal complaint during pregnancy, often managed with lifestyle and dietary changes.

Option B: Insomnia during pregnancy is multifactorial and not directly caused by smooth muscle relaxation. It is often due to physical discomfort from the growing uterus, frequent urination, fetal movements, and anxiety.
Option C: Back pain is primarily a musculoskeletal issue in pregnancy. It is caused by the shifting center of gravity, increased weight, and the effects of the hormone relaxin, which loosens ligaments in the pelvic area.
Option D: Leg swelling (edema) is mainly a circulatory issue. It results from the pressure of the enlarged uterus on the inferior vena cava and pelvic veins, which slows blood return from the lower extremities, combined with an increase in total body fluid.

Visual 1: Diagram - A diagram illustrating the anatomy of the upper gastrointestinal tract. It should show the esophagus, the lower esophageal sphincter (LES), and the stomach. An inset should compare a closed LES in a non-pregnant state to a relaxed LES in a pregnant state, with an arrow indicating the reflux of stomach acid into the esophagus.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Physiological changes and common discomforts during pregnancy, specifically the hormonal effects of progesterone as background academic context rather than a clinical decision trigger.
Nurses play a key role in educating pregnant women about managing common discomforts like reflux.
Key nursing interventions include advising small, frequent meals; avoiding spicy, fatty, or acidic foods; not lying down immediately after eating; and elevating the head of the bed.
What if? If a patient's reflux is severe and not managed by lifestyle changes, a nurse should advise her to consult her healthcare provider, as antacids or other medications may be necessary. It's crucial to only use medications approved for pregnancy.

How to Approach the Question

First, identify the key physiological mechanism mentioned in the question: increased progesterone causing relaxation of smooth muscle.
Next, evaluate each option to determine which condition is a direct consequence of this mechanism.
Recall or deduce the primary cause of each discomfort listed.
Reflux disease (heartburn) is caused by the relaxation of the lower esophageal sphincter, a smooth muscle. This matches the question's premise.
Rule out the other options by identifying their primary causes: Insomnia (multifactorial), Back pain (mechanical/ligamentous), and Leg swelling (circulatory/mechanical pressure).
Select the option that directly links to progesterone's effect on smooth muscle.

Concept Tested & Keywords

Concept Tested: Physiological changes and common discomforts during pregnancy, specifically the hormonal effects of progesterone.
Stem keywords: minor discomfort, pregnancy, progesterone, smooth muscle
Lead-in keywords: Which

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