A nurse is assisting with the admission of a client who has hyperemesis gravidarum. Which of the following laboratory tests is the priority to complete?

Serum bilirubin

Liver enzymes

Urinalysis for ketones

CBC

Answer and Explanation

The Correct Answer is C

(a) Serum bilirubin:
While serum bilirubin can provide useful information about liver function, it is not the most immediate concern for a client with hyperemesis gravidarum. This condition primarily involves severe nausea and vomiting, which can lead to dehydration and ketosis.

(b) Liver enzymes:
Liver enzymes can be elevated in hyperemesis gravidarum, but they are not the primary concern. The immediate priority is to assess the extent of dehydration and metabolic disturbances.

(c) Urinalysis for ketones:
This test is the priority because it helps determine the extent of dehydration and ketosis. In hyperemesis gravidarum, severe vomiting can lead to significant fluid and electrolyte imbalances and ketosis, which need to be identified and corrected promptly to prevent further complications.

(d) CBC:
A complete blood count (CBC) provides useful information about overall health and can identify anemia or infection, but it is not the priority for immediate assessment of hyperemesis gravidarum. The immediate need is to evaluate hydration status and ketosis, which is best done through urinalysis for ketones.

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Correct Answer is A

Explanation

(a) Supine
Placing the newborn in the supine position (on their back) for sleep is recommended by pediatric guidelines to reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related causes of infant death. The supine position allows for optimal airway patency and decreases the risk of suffocation. This position is safest for the newborn during sleep.

(b) Prone
Placing the newborn in the prone position (on their stomach) for sleep is not recommended due to an increased risk of SIDS. The prone position can obstruct the infant's airway and increase the risk of suffocation or overheating, leading to adverse outcomes.

(c) Left lateral
While placing the newborn on the left side may be recommended for certain medical procedures or interventions, such as feeding to reduce reflux, it is not recommended for sleep positioning. Placing the newborn in the left lateral position during sleep does not provide the same benefits for airway patency and SIDS risk reduction as the supine position.

(d) Right lateral
Similar to the left lateral position, placing the newborn on the right-side during sleep does not offer the same protective benefits as the supine position. It does not reduce the risk of SIDS and may pose similar risks as the prone position, such as airway obstruction.

A. Increased fundal height B. Poor skin turgor C. Decreased pulse rate D. Proteinuria

Correct Answer is B

Explanation

(A) Increased fundal height:
Hyperemesis gravidarum, severe nausea, and vomiting during pregnancy, typically does not cause an increased fundal height. Fundal height may be normal or even decreased due to dehydration and weight loss.

(B) Poor skin turgor:
Poor skin turgor is a common finding in clients with hyperemesis gravidarum due to dehydration. Excessive vomiting leads to fluid loss and dehydration, resulting in poor skin elasticity and turgor.

(C) Decreased pulse rate:
Hyperemesis gravidarum usually results in dehydration and hypovolemia, which can lead to an increased heart rate rather than a decreased pulse rate. The body compensates for decreased fluid volume by increasing the heart rate to maintain adequate circulation.

(D) Proteinuria:
Proteinuria, the presence of abnormal amounts of protein in the urine, is not typically associated with hyperemesis gravidarum. Proteinuria can be a sign of kidney dysfunction or other medical conditions but is not directly related to severe nausea and vomiting during pregnancy.

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A nurse is assisting with the admission of a client who has hyperemesis gravidarum. Which of the following laboratory tests is the priority to complete?

Nursing Test Bank

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