PMC PMC Circulatory & Lymphatic Considerations 1 — Questions and Answers
Question 1: Why does blood volume increase significantly during pregnancy?
- To support placental perfusion and fetal oxygen delivery (Correct answer)
- To prepare the body for postpartum weight loss
- To increase maternal blood pressure
- To support increased digestive activity
Correct answer: To support placental perfusion and fetal oxygen delivery
Blood volume increases by approximately 40–50% during pregnancy to ensure adequate oxygen and nutrient delivery to the placenta and fetus.
Question 2: What condition describes abnormally enlarged, twisted veins that commonly appear in the legs during pregnancy?
- Varicose veins (Correct answer)
- Deep vein thrombosis
- Lymphedema
- Phlebitis
Correct answer: Varicose veins
Varicose veins result from increased venous pressure and progesterone-induced vascular relaxation during pregnancy.
Question 3: Which direction should effleurage strokes be performed on a pregnant client's legs to support venous return?
- Distal to proximal (toward the heart) (Correct answer)
- Proximal to distal (away from the heart)
- Lateral to medial
- In a circular pattern only
Correct answer: Distal to proximal (toward the heart)
Strokes directed toward the heart (distal to proximal) assist venous return and reduce peripheral edema.
Question 4: A pregnant client develops visible varicose veins behind her knee. How should the therapist approach this area?
- Avoid direct pressure on the varicosities and work around them (Correct answer)
- Apply deep friction to break up the distended vessels
- Use hot compresses over the area before massage
- Massage directly over them with light effleurage only
Correct answer: Avoid direct pressure on the varicosities and work around them
Direct pressure on varicose veins can damage fragile vessel walls and increase risk of thrombosis or rupture.
Question 5: What is the primary reason deep vein thrombosis (DVT) risk increases during pregnancy?
- Hypercoagulability, venous stasis, and vascular endothelial damage (Virchow's Triad) (Correct answer)
- Increased physical activity during pregnancy
- Decreased fluid intake
- Reduced heart rate during the third trimester
Correct answer: Hypercoagulability, venous stasis, and vascular endothelial damage (Virchow's Triad)
Pregnancy activates Virchow's Triad — increased clotting factors, reduced blood flow velocity, and vessel wall changes — all raising DVT risk.
Question 6: Which symptom combination in a pregnant client's calf should immediately lead the therapist to stop massage and refer to emergency care?
- Unilateral heat, redness, swelling, and tenderness (Correct answer)
- Bilateral mild soreness after exercise
- Bilateral ankle edema at end of day
- Calf cramping that resolves with dorsiflexion
Correct answer: Unilateral heat, redness, swelling, and tenderness
Unilateral calf heat, redness, swelling, and tenderness are classic DVT signs, which are a medical emergency contraindicating massage.
PMC PMC Circulatory & Lymphatic Considerations 1
Why does blood volume increase significantly during pregnancy?