— 健康促進與維護 · MEDIUM · SATA —
護理師評估一位懷孕第二孕期的個案。下列哪些發現屬於正常的生理變化？（選所有適合的）
A nurse is assessing a pregnant client in her second trimester. Which findings should the nurse identify as normal physiological changes? (Select all that apply.)
- AIncreased tidal volume✓ 正解潮氣容積增加
- BHyperpigmentation of the areolae✓ 正解乳暈色素沉著
- CDecreased white blood cell count白血球計數減少
- DSupine hypotension syndrome仰臥低血壓症候群
- EPhysiological anemia due to hemodilution✓ 正解因血液稀釋所致之生理性貧血
— Explanation · 中文詳解 —
懷孕期間為適應胎兒需求，肺部潮氣容積會增加以獲得更多氧氣。荷爾蒙改變（如 MSH）會導致色素沉澱，如乳暈變深。血漿容積增加大於紅血球增加，形成血液稀釋導致生理性貧血。C 錯誤：白血球在懷孕期間通常會輕微上升。D 錯誤：仰臥低血壓是病理性變化，應避免。
Normal physiological changes in pregnancy include increased tidal volume to meet fetal oxygen demands, hyperpigmentation of the areolae due to hormonal effects, and physiological anemia caused by hemodilution from plasma volume expansion exceeding red blood cell production. Leukocyte counts typically increase, and supine hypotension is a pathological condition to be avoided.
✦ 台美臨床差異
美國護理師執行產檢衛教時更強調姿勢調整避免仰臥低血壓；台灣臨床則由產科醫師主導產檢，護理師較少進行詳細生理變化指導。