A nurse is caring for a client who inquires about a cervical cap for contraception.The nurse should identify that which of the following manifestations is a contraindication for the use of a cervical cap?

Choice A rationale

"Decreased BP.”. This is correct because hyperemesis gravidarum can lead to dehydration, which in turn can cause hypotension (decreased blood pressure).

Choice B rationale

"WBC count 15,000/mm³ (5,000 to 15,000/mm³).”. This is incorrect because while WBC count can be elevated due to stress or infection, it is not a primary manifestation of hyperemesis gravidarum.

Choice C rationale

"Pruritus.”. This is incorrect because pruritus is not commonly associated with hyperemesis gravidarum. It is more likely related to other conditions like cholestasis of pregnancy.

Choice D rationale

"Hemoglobin 18 g/dL (11 to 16 g/dL).”. This is incorrect because an elevated hemoglobin level is not a direct manifestation of hyperemesis gravidarum, although dehydration can potentially concentrate blood components and slightly elevate hemoglobin.

The nurse should prepare to reinforce teaching with the client about a low-sodium diet with a prescription of nifedipine.

So, the correct options are:

1. C. low-sodium diet
2. A. nifedipine

Explanation:

1. Low-sodium diet:
   • The client has a history of obesity and hypertension, which are both managed effectively with a low-sodium diet. Reducing sodium intake can help lower blood pressure and reduce the risk of complications.
2. Nifedipine:
   • The client has been prescribed nifedipine, which is a medication used to treat high blood pressure. This aligns with her history of hypertension and the current elevated blood pressure readings.