A client in the third trimester experiences frequent nasal stiffness and nosebleeds. Her chest circumference has increased by 5 cm during pregnancy, she uses thoracic breathing, her diaphragm is elevated, and she has an increased costal angle. Which intervention should the nurse implement?

A client in the third trimester experiences frequent nasal stiffness and nosebleeds. Her chest circumference has increased by 5 cm during pregnancy, she uses thoracic breathing, her diaphragm is elevated, and she has an increased costal angle. Which intervention should the nurse implement?

• A. Record the respiratory findings in the client's record as normal.
• B. Encourage the client to perform rapid breathing exercises.
• C. Administer a nasal decongestant.
• D. Place the client in a side-lying position.

Answer: (A)

In late pregnancy, many respiratory changes are normal due to hormonal effects and the growing uterus. The diaphragm is pushed upward, the chest wall expands, and the rib cage becomes more leveraged, which explains the increased chest circumference, thoracic breathing pattern, and a higher costal angle. Nasal stiffness and nosebleeds are also common from estrogen-driven mucosal edema. These findings don’t indicate a problem; they reflect typical physiologic adaptations. Therefore, the appropriate action is to record these respiratory findings as normal and continue routine prenatal care. The other options aren’t needed here: rapid breathing exercises aren’t indicated and could disrupt comfort; nasal decongestants carry potential risks for mother and fetus; placing the patient in a side-lying position helps with venous return but doesn’t address the described normal respiratory adaptations.

In late pregnancy, many respiratory changes are normal due to hormonal effects and the growing uterus. The diaphragm is pushed upward, the chest wall expands, and the rib cage becomes more leveraged, which explains the increased chest circumference, thoracic breathing pattern, and a higher costal angle. Nasal stiffness and nosebleeds are also common from estrogen-driven mucosal edema. These findings don’t indicate a problem; they reflect typical physiologic adaptations.

Therefore, the appropriate action is to record these respiratory findings as normal and continue routine prenatal care. The other options aren’t needed here: rapid breathing exercises aren’t indicated and could disrupt comfort; nasal decongestants carry potential risks for mother and fetus; placing the patient in a side-lying position helps with venous return but doesn’t address the described normal respiratory adaptations.