NCLEX Question for Class 3 Cardiac Disease Priority Nursing Diagnosis

A pregnant client with class 3 cardiac disease is seen during an initial prenatal visit. The nurse selects which of the following priority nursing diagnoses”
 

a.    Knowledge deficit related to self-care during pregnancy.

b.    Fear, client and family, related to pregnancy outcome

c.    Alteration in nutrition related to sodium-restricted diet.

d.    Activity intolerance related to compromised cardiac status

Correct Answer D:. Once pregnancy is established, the focus of management is on minimizing any extra cardiac demands on the pregnant woman.  In class 3 cardiac disease, the client experiences fatigue, palpitation, dyspnea, or angina when she undertakes less than ordinary activity.  Physical activity is markedly restricted; this includes bedrest throughout the pregnancy.
 

Pregnant women with cardiac disease do need to learn self-care to minimize the risk of complications; this, however, does not take priority over physiologic safety.
 

Pregnancies with serious complications instill fear in the client and family; however, physiological needs take priority.
 

Pregnant women with cardiac disease are likely to be placed on a sodium-restricted diet; however, this does not take priority over the risk of cardiac decompensation.

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