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.)

A. Increase the rate of maintenance IV infusion. Increasing IV fluids may help improve placental perfusion, but it is not the first action. Repositioning the client takes priority to improve blood flow before considering IV adjustments.

B. Administer oxygen using a nonrebreather mask. Oxygen is beneficial in improving fetal oxygenation, but positioning the client laterally should be done first to optimize blood flow before oxygen administration.

C. Elevate the client’s legs. Elevating the legs may be helpful in cases of hypotension, but this scenario describes late decelerations, which are related to uteroplacental insufficiency.

D. Place the client in the lateral position. Late decelerations are caused by uteroplacental insufficiency, leading to fetal hypoxia. The first action is to reposition the client to the lateral position, which improves blood flow to the placenta and enhances fetal oxygenation.

A. Maternal heart rate: While the maternal heart rate is important, it is not directly related to interpreting FHR patterns. However, it is necessary to differentiate between the maternal and fetal heart rate on the monitor.

B. Gestational age: While gestational age affects fetal heart rate (younger fetuses tend to have higher baseline rates), it is not a direct component of FHR interpretation.

C. Uterine contractions: Uterine contractions are crucial in FHR interpretation because they influence perfusion to the fetus. Decelerations occurring with contractions may indicate fetal distress (e.g., late decelerations suggest uteroplacental insufficiency).

D. Presence of accelerations and decelerations: Accelerations and decelerations provide key information about fetal well-being. Accelerations indicate fetal well-being, while decelerations may signal hypoxia, cord compression, or uteroplacental insufficiency.