A nurse is caring for a pregnant client who is diagnosed with hyperemesis gravidarum. Which of the following interventions should the nurse prioritize for the pregnant client with hyperemesis gravidarum?

Encourage the client to increase dietary intake to meet nutritional needs.

Provide emotional support and counseling to address psychological distress.

Administer intravenous fluids to correct dehydration and electrolyte imbalances.

Monitor fetal growth and development through regular ultrasound scans.

Answer and Explanation

The Correct Answer is C

A. Encourage the client to increase dietary intake to meet nutritional needs: Clients with hyperemesis gravidarum often cannot tolerate oral intake due to persistent vomiting. Encouraging food consumption without addressing dehydration and nausea first is ineffective and may worsen symptoms.

B. Provide emotional support and counseling to address psychological distress: Psychological support is important, as hyperemesis can be emotionally taxing. However, physical stabilization through hydration and electrolyte correction takes precedence before addressing emotional needs.

C. Administer intravenous fluids to correct dehydration and electrolyte imbalances: The priority in managing hyperemesis gravidarum is rehydration and correction of imbalances caused by prolonged vomiting. IV fluids help restore circulatory volume, normalize electrolytes, and stabilize the client’s condition.

D. Monitor fetal growth and development through regular ultrasound scans: Although fetal monitoring is necessary, especially in prolonged cases, it is not the immediate priority. Stabilizing the mother's fluid and electrolyte status must occur first to support both maternal and fetal health.

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Correct Answer is D

Explanation

A. Congenital heart defects: While some environmental exposures may increase the risk of congenital anomalies, smoking is more closely linked with placental and growth complications rather than structural heart defects in the fetus.

B. Hearing loss: Hearing loss in newborns is commonly associated with infections, genetic conditions, or exposure to ototoxic medications. Maternal smoking has not been strongly linked to this outcome in pregnancy.

C. Type 1 diabetes mellitus: Type 1 diabetes is an autoimmune condition with a strong genetic component. Smoking during pregnancy does not contribute to the development of this chronic disease in infants.

D. Intrauterine growth restriction: Nicotine causes vasoconstriction and reduces placental perfusion, leading to decreased oxygen and nutrient delivery to the fetus. This significantly increases the risk of intrauterine growth restriction and low birth weight.

A. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding B. A client who has missed a period and reports vaginal spotting C. A client who is at 38 weeks of gestation and reports a cough and fever D. A client who is at 14 weeks of gestation and reports intractable nausea and vomiting

Correct Answer is A

Explanation

A. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding: Painless vaginal bleeding in the second or third trimester may indicate placenta previa, a potentially life-threatening condition. This requires immediate evaluation to assess maternal and fetal well-being. Delayed assessment could result in severe hemorrhage. Therefore, this client is the top priority.

B. A client who has missed a period and reports vaginal spotting: This may suggest early pregnancy or a possible miscarriage, but it is typically less urgent. While the client needs evaluation, it is unlikely to be life-threatening at this stage. This can be triaged after more critical cases are stabilized.

C. A client who is at 38 weeks of gestation and reports a cough and fever: Though a respiratory infection is concerning, it is generally not immediately life-threatening. The client should be assessed for infection and fetal well-being, but it does not override active vaginal bleeding. This client is stable enough to wait a short while.

D. A client who is at 14 weeks of gestation and reports intractable nausea and vomiting: This may indicate hyperemesis gravidarum, which can lead to dehydration and electrolyte imbalance. Although serious, it typically does not pose an immediate threat to life. The condition requires treatment but is not the most urgent in this group.

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A nurse is caring for a pregnant client who is diagnosed with hyperemesis gravidarum. Which of the following interventions should the nurse prioritize for the pregnant client with hyperemesis gravidarum?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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