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

Answer and Explanation

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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Correct Answer is A

Explanation

A. First stage, latent phase: The first stage of labor consists of the latent, active, and transition phases. Latent phase: Cervical dilation 0-3 cm, contractions mild and irregular (every 5-10 minutes, lasting 30-45 seconds). Client in this scenario matches these criteria.

B. Second stage of labor: The second stage of labor begins at full cervical dilation (10 cm) and ends with birth. The client is only 2 cm dilated, so she is still in the first stage.

C. First stage, active phase: The active phase of labor occurs when the cervix is 4-7 cm dilated and contractions are stronger, longer, and more frequent (every 3-5 minutes). The client is only 2 cm dilated, so she is still in the latent phase.

D. First stage, transition phase: The transition phase occurs when the cervix is 8-10 cm dilated, and contractions occur every 2-3 minutes, lasting 60-90 seconds. The client is far from this stage.

A. Increase the client's IV fluid infusion rate. B. Palpate the client's uterus. C. Administer oxygen to the client. D. Turn the client onto her side.

Correct Answer is D

Explanation

A. Increase the client's IV fluid infusion rate. While increasing IV fluids can improve placental perfusion, the priority intervention for late decelerations is repositioning the client to relieve uteroplacental insufficiency.

B. Palpate the client's uterus. Uterine palpation helps assess for tachysystole (excessive contractions), which could contribute to late decelerations. However, this is not the priority intervention.

C. Administer oxygen to the client. Oxygen administration (8-10 L/min via face mask) improves fetal oxygenation, but repositioning the client should be done first to relieve pressure on the placenta.

D. Turn the client onto her side. Repositioning the client to the left or right lateral position improves uteroplacental circulation and reduces compression of the inferior vena cava, increasing blood flow to the fetus.

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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.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client having contractions every 8 min that are 30 to 40 seconds in duration. The client's cervix is 2 cm dilated, 50% effaced, and the fetus is at a -2 station with a FHR around 140/min. Which of the following stages and phases of labor is the client experiencing?

Correct Answer is A

Explanation

A nurse is caring for a client who is in active labor when the client's membranes rupture. The fetal monitor tracing shows late decelerations. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

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