A nurse is caring for a 20-year-old female client in an antepartum unit. The client is a primigravida at 11 weeks of gestation and reports increased nausea and vomiting within the past week, with decreased appetite. The client denies abdominal or epigastric pain but notes weight loss of 2.8 kg (6.2 lb) over the past two weeks.
Complete the diagram by dragging from the choices below to specify:
- The condition the client is most likely experiencing.
- Two actions the nurse should take to address the condition.
- Two parameters the nurse should monitor to assess the client's progress.
The Correct Answer is []
Rationale for correct condition: Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy, leading to dehydration, weight loss, and electrolyte imbalance. The client's significant weight loss of 2.8 kg (6.2 lb) in two weeks, increased nausea and vomiting, and decreased appetite are classic symptoms. The elevated BUN level suggests dehydration, which aligns with hyperemesis gravidarum. The absence of abdominal pain and the presence of facial pallor further support this condition.
Rationale for actions:
- Initiate IV fluid therapy to rehydrate the client and correct electrolyte imbalances caused by excessive vomiting.
- Administer ondansetron IV to control nausea and vomiting, improving the client's ability to tolerate oral intake.
Rationale for parameters:
- Weight should be monitored to assess the effectiveness of interventions and ensure the client is regaining or maintaining a healthy weight.
- Urine output indicates hydration status and kidney function, helping to evaluate the adequacy of fluid replacement.
Rationale for incorrect conditions:
- Cholecystitis: The client denies abdominal or epigastric pain, which is a key symptom of cholecystitis.
- Gestational diabetes mellitus: There is no mention of elevated blood glucose levels or other diabetic symptoms.
- Preeclampsia: The client's blood pressure is within normal range, and there are no signs of hypertension or proteinuria.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Intrauterine growth restriction (IUGR) is a significant risk for newborns of mothers who smoke. Smoking affects placental blood flow, reducing the supply of oxygen and nutrients to the fetus, leading to poor growth.
Choice B rationale
Smoking is not a direct cause of gestational diabetes. Gestational diabetes is primarily related to hormonal changes in pregnancy that affect insulin regulation.
Choice C rationale
Congenital heart defects are not directly linked to smoking. They are usually caused by genetic and environmental factors during early fetal development, not smoking specifically.
Choice D rationale
Vision loss is not directly associated with maternal smoking. Smoking affects fetal growth and development, but vision loss is not a common outcome.
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Basal body temperature drops slightly for 24-48 hours before ovulation, indicating the most fertile period.
Choice B rationale
Luteinizing hormone surges just before ovulation, triggering the release of an egg from the ovary.
Choice C rationale
Vaginal acidity does not significantly decrease during ovulation; it remains relatively constant.
Choice D rationale
Libido often rises during ovulation due to hormonal changes, which can increase the chances of conception.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.