What is a key vital sign complication the nurse should monitor in a pregnant client with heart disease?

• A. Decrease in heart rate
• B. Increase in circulating volume
• C. Drop in blood pressure
• D. Stable fetal heart rate

Answer: (B)

In the context of a pregnant client with heart disease, monitoring for an increase in circulating volume is crucial because pregnancy naturally involves physiological changes that affect the cardiovascular system. During pregnancy, there is an increase in plasma volume, which can exacerbate existing heart conditions.

For a client with heart disease, an increase in circulating volume can lead to fluid overload, increased cardiac workload, and may precipitate heart failure or other complications. The heart's limited capacity to handle increased volume can lead to significant distress and symptoms like edema, shortness of breath, or increased fatigue.

While it is important to monitor other vital signs such as heart rate, blood pressure, and fetal heart rate, an increase in circulating volume is especially critical to watch in this population, as it has direct implications for the mother's cardiovascular stability and the well-being of the fetus.