A client with severe hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What would the nurse expect to include in the client's plan of care?
clear liquid diet
administration of labetalol
small frequent meals
nothing by mouth
The Correct Answer is D
A. Clear liquid diet may be appropriate later in treatment once symptoms improve, but it is not typically initiated immediately in a client with severe hyperemesis gravidarum, especially if they are unable to keep any fluids down.
B. Administration of labetalol is used to treat hypertension, particularly in preeclampsia, and is not related to the treatment of hyperemesis gravidarum.
C. Small frequent meals are part of long-term management or mild cases, but for severe hyperemesis gravidarum requiring hospitalization, oral intake is usually withheld initially.
D. Nothing by mouth (NPO) is correct. In severe hyperemesis gravidarum, the client is often kept NPO to rest the gastrointestinal tract and prevent further vomiting. Intravenous (IV) fluids, electrolytes, and sometimes antiemetic medications are administered to manage dehydration and nutritional deficits before gradually resuming oral intake.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Ice helps to reduce swelling, numb the area, and relieve pain during the first 24 hours after an episiotomy. Applying ice immediately after birth can help minimize discomfort and inflammation.
B. Offer warm blankets may provide comfort but will not specifically target pain relief or swelling at the site of the episiotomy.
C. Offer a warm sitz bath is beneficial for postpartum healing and pain relief but should not be used immediately after the procedure. Warm sitz baths are typically recommended after the first 24 hours to promote relaxation and improve blood circulation.
D. Encourage the woman to void is important for overall comfort and bladder function but will not directly address the pain from the episiotomy.
Correct Answer is ["A","D"]
Explanation
A. Dark red vaginal bleeding is often seen in placental abruption. The blood from an abruption is typically dark red (indicating that it is older blood) and may be mixed with amniotic fluid, making it more challenging to assess. However, the bleeding can sometimes be concealed, especially in complete abruption or retroplacental hemorrhage, where blood accumulates behind the placenta.
B. Absence of pain is incorrect. In fact, placental abruption is typically associated with abdominal pain, which can be severe and often comes on suddenly. Pain occurs due to the detachment of the placenta from the uterine wall and subsequent irritation or bleeding into the uterine cavity.
C. Insidious onset is incorrect. Placental abruption usually has a sudden or acute onset of symptoms, such as vaginal bleeding and abdominal pain. An insidious onset would be more suggestive of other conditions, such as placenta previa.
D. Absent fetal heart tones is a critical finding. Placental abruption can cause fetal distress or fetal death, especially if the abruption is severe. Absent fetal heart tones are a sign of fetal compromise or death resulting from the disruption of placental blood flow.
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