A nurse is assessing a client at 10 weeks of gestation who has been diagnosed with hyperemesis gravidarum. Which of the following manifestations should the nurse expect? (Select all that apply.)
Weight loss
Abdominal cramping
Severe vomiting
Electrolyte imbalance
Vaginal blood spotting
Correct Answer : A,C,D
A. Weight loss: Severe and prolonged nausea/vomiting leads to weight loss (>5% of pre-pregnancy weight). This is a key feature of hyperemesis gravidarum.
B. Abdominal cramping: Hyperemesis gravidarum does not cause abdominal cramping. Cramping is more associated with miscarriage, ectopic pregnancy, or gastrointestinal conditions.
C. Severe vomiting: Persistent, severe vomiting is the hallmark sign of hyperemesis gravidarum. It is much more severe than typical morning sickness and leads to dehydration and nutritional deficiencies.
D. Electrolyte imbalance: Prolonged vomiting leads to dehydration and loss of essential electrolytes (e.g., hypokalemia, hyponatremia, metabolic alkalosis).
E. Vaginal blood spotting: Hyperemesis gravidarum does not cause vaginal bleeding. Vaginal spotting could indicate a miscarriage or another obstetric complication.
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Related Questions
Correct Answer is B
Explanation
A. To stimulate uterine contractions: Terbutaline is a tocolytic (a medication that relaxes the uterus), not a uterotonic. It is not used to stimulate contractions.
B. To improve placental blood flow: Terbutaline relaxes uterine muscles, decreasing contraction frequency and intensity, thereby improving placental blood flow. It is often used in intrauterine resuscitation when there is uteroplacental insufficiency and fetal distress due to excessive contractions (tachysystole).
C. To decrease fetal heart rate variability: Terbutaline does not directly affect fetal heart rate variability. It is used to reduce uterine contractions, which can secondarily improve fetal oxygenation.
D. To prevent preterm labor: While terbutaline can be used to delay preterm labor, in this context, it is being used for intrauterine resuscitation, not for preventing labor.
Correct Answer is A
Explanation
A. Contractions that last for 60 seconds each with a 2-min rest between contractions. If contractions are 3 minutes apart, this means the interval from the start of one contraction to the start of the next is 3 minutes. If each contraction lasts for 60 seconds, there will be a 2-minute rest period before the next contraction begins.
B. Contractions that last for 60 seconds each with a 3-min rest between contractions. This would indicate contractions occurring every 4 minutes, not every 3 minutes.
C. A contraction that lasts 3 min followed by a period of relaxation. A contraction lasting 3 minutes is abnormal and suggests uterine tachysystole, which can be dangerous.
D. Contractions that last 45 seconds each with a 2-min rest between contractions. If contractions last 45 seconds, the remaining rest period would be 2 min 15 sec, not exactly 2 minutes.
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