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.

Exhibits

Complete the diagram by dragging from the choices below to specify:

1. The condition the client is most likely experiencing.
2. Two actions the nurse should take to address the condition.
3. Two parameters the nurse should monitor to assess the client's progress.

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:

1. Initiate IV fluid therapy to rehydrate the client and correct electrolyte imbalances caused by excessive vomiting.
2. Administer ondansetron IV to control nausea and vomiting, improving the client's ability to tolerate oral intake.

Rationale for parameters:

1. Weight should be monitored to assess the effectiveness of interventions and ensure the client is regaining or maintaining a healthy weight.
2. 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.

Choice A rationale

During pregnancy, there is an increase in fibrinogen and a decrease in fibrinolysis. These changes increase the risk of thromboembolic events, as they promote clot formation.

Choice B rationale

Increased blood volume and cardiac output are normal in pregnancy but do not directly increase the risk of thromboembolic events. They are adaptations to meet the increased metabolic demands.

Choice C rationale

Decreased hematocrit and increased RBC levels are typical in pregnancy but are related to the physiological dilution of blood, not thromboembolic risks.

Choice D rationale

Decreased blood pressure and hemoglobin are common in pregnancy due to increased blood volume but are not associated with increased thromboembolic risks. .