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?

A. Insert an indwelling urinary catheter: While a catheter may be necessary later for monitoring output or surgical prep, it is not the most urgent need. Ensuring circulatory access to manage potential hemorrhage takes priority over urinary concerns.

B. Witness the signature for informed consent for surgery: Although consent is important if an emergency cesarean becomes necessary, stabilizing the client’s condition first is critical. Legal paperwork should not delay immediate life-saving interventions.

C. Prepare the abdominal and perineal areas: Preparation for surgery may be required, but it is secondary to stabilizing the client. Without IV access, essential fluids, medications, or blood products cannot be administered during active bleeding.

D. Initiate IV access: The client shows signs of possible hypovolemia from bleeding, with tachycardia and low blood pressure. Rapid IV access is the top priority to administer fluids or blood products and support maternal and fetal well-being.

A. I should report any pain, burning, or itching associated with the vaginal discharge: Pain, itching, or burning are signs of possible infection and should be reported promptly. These symptoms are not typical of normal pregnancy changes. Reporting them helps prevent complications. This statement reflects appropriate understanding.

B. I understand that an increase in vaginal discharge is normal during pregnancy: Hormonal changes during pregnancy lead to increased vaginal secretions. This discharge, known as leukorrhea, is usually clear or white and non-irritating. Recognizing this as normal indicates correct learning.

C. I should be concerned if I experience a white, odorless vaginal discharge: White, odorless discharge is considered normal in pregnancy and does not require concern. Thinking it is abnormal shows a misunderstanding of physiological changes. This indicates a need for further education about normal discharge patterns.

D. My vaginal walls may appear bluish due to increased blood flow: Increased vascularization causes a bluish discoloration of the vaginal mucosa, known as Chadwick’s sign. It is a normal early sign of pregnancy. The client’s awareness of this change reflects accurate knowledge.