A nurse is providing education to a client during her first prenatal visit.
Which of the following should the nurse include in the teaching to decrease the risk of preterm labor?

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.

Weight loss of 2.8 kg (6.2 lb): Consistent - Significant weight loss is a classic symptom of hyperemesis gravidarum. The client has lost more than 5% of her pre-pregnancy weight, which is concerning and supports this diagnosis.

Hematocrit: 30%: Not Consistent - Hematocrit measures the proportion of red blood cells in the blood. In hyperemesis gravidarum, the hematocrit may be elevated due to dehydration, not decreased. Therefore, this value is not consistent with the typical presentation.

Vaginal spotting: Not Relevant - While vaginal spotting can be concerning in pregnancy, it is not a specific sign of hyperemesis gravidarum and does not directly relate to the diagnosis of severe nausea and vomiting.

Heart rate: 110/min: Consistent - Tachycardia (elevated heart rate) can occur due to dehydration and the body’s response to prolonged vomiting, making this finding consistent with hyperemesis gravidarum.

BUN: 28 mg/dL: Consistent - Blood urea nitrogen (BUN) is elevated in this client, suggesting dehydration. Dehydration is a common complication of hyperemesis gravidarum due to persistent vomiting and poor oral intake.