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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
A. Fetal breathing: Fetal breathing movements are assessed as part of the BPP, which evaluates fetal well-being.
B. Fetal motion: Fetal movements, including limb and body movements, are an essential component of the BPP.
C. Amniotic fluid volume: The amount of amniotic fluid is measured to assess fetal hydration and placental function.
D. Fetal gender: The BPP does not assess fetal gender; it focuses on fetal well-being rather than genetic characteristics.
E. Fetal neck translucency: Nuchal translucency (fetal neck thickness) is assessed during first-trimester ultrasound screening for chromosomal abnormalities, not during a BPP.
Correct Answer is D
Explanation
A. Antenatal steroid administration: Antenatal steroids (e.g., betamethasone) are used to enhance fetal lung maturity in preterm pregnancies (<34 weeks). At 35 weeks, steroids are generally not indicated.
B. Expectant management protocols: Expectant management (delaying delivery with close monitoring) is considered in mild preeclampsia but is not appropriate in severe preeclampsia due to the risk of maternal and fetal complications.
C. Method of birth: The method of birth (vaginal vs. C-section) is determined based on maternal and fetal conditions. While important, it is not the key consideration in addressing the client's concern about their birth plan.
D. Shared decision-making: Shared decision-making ensures that the client feels heard and involved in their care plan, even in urgent situations. The nurse should acknowledge the client's concerns, explain the rationale for induction, and explore possible accommodations for their birth plan.
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